The role of vitamin D in mild to moderate chronic kidney disease.pdf

Review TRENDS in Endocrinology Metabolism Vol.13 No.5 July 2002 189 The role of vitamin D in mild to moderate chronic kidney disease Theodore C. Friedman and Keith C. Norris Dietary vitamin D is a prohormone that is metabolized to the bioactive The identification of the VDR in many other vitamin D hormone, 1αα,25-dihydroxyvitamin D [1,25-(OH) D]. 1,25-(OH) D has tissues, together with studies using radiolabeled 2 2 been implicated in a variety of regulatory pathways that extend well beyond its 1,25-(OH) D, suggests that 1,25-(OH) D controls a 2 2 traditional function in Ca2++ homeostasis. In uncovering these diverse functions, wide range of physiological functions (Table 1). These investigators have focused on the complex interaction between 1,25-(OH)2D functions include regulation of PTH synthesis and and parathyroid hormone (PTH). Here, we present an overview of the functions secretion, differentiation of keratinocytes, the of vitamin D hormone and PTH in the clinical context of secondary immune response, secretion of insulin and hyperparathyroidism. We discuss recent developments in treatment that reproductive organ development [1]. address imbalances in vitamin D hormone and PTH levels, supporting the Because the final step in the activation of argument that early intervention can reduce the risk of metabolic vitamin D occurs in the kidney, it is not surprising complications caused by vitamin D