Next Article in Journal
Health Effects of Resveratrol: Results from Human Intervention Trials
Next Article in Special Issue
Prevalence and Correlates of Sarcopenia among Elderly CKD Outpatients on Tertiary Care
Previous Article in Journal
Administration of Momordica charantia Enhances the Neuroprotection and Reduces the Side Effects of LiCl in the Treatment of Alzheimer’s Disease
Previous Article in Special Issue
Energy-Dense Diets and Mineral Metabolism in the Context of Chronic Kidney Disease–Metabolic Bone Disease (CKD-MBD)
Article Menu

Export Article

Open AccessReview
Nutrients 2018, 10(12), 1890; https://doi.org/10.3390/nu10121890

The Emerging Role of Nutritional Vitamin D in Secondary Hyperparathyroidism in CKD

1
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
2
Division of Nephrology, Department of Medicine, Fu Jen Catholic University Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan
3
Division of Cardiology, Department of Medicine, Fu Jen Catholic University Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan
4
Division of Nephrology, Department of Medicine, Cardinal-Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City 23155, Taiwan
5
Division of Nephrology, Department of Internal Medicine, Tungs’ Taichung MetroHarbor Hospital, Taichung City 433, Taiwan
6
Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, New Taipei City 235, Taiwan
7
Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11103, Taiwan
8
Department of Biology and Anatomy, National Defense Medical Center, Taipei 114, Taiwan
9
Kidney Dialysis Center, Kamifukuoka General Hospital, Saitama 356, Japan
10
Department of Medicine, Show-Chwan Memorial Hospital, Changhua 50008, Taiwan
*
Author to whom correspondence should be addressed.
Received: 13 September 2018 / Revised: 22 November 2018 / Accepted: 23 November 2018 / Published: 3 December 2018
Full-Text   |   PDF [1318 KB, uploaded 3 December 2018]   |  

Abstract

In chronic kidney disease (CKD), hyperphosphatemia induces fibroblast growth factor-23 (FGF-23) expression that disturbs renal 1,25-dihydroxy vitamin D (1,25D) synthesis; thereby increasing parathyroid hormone (PTH) production. FGF-23 acts on the parathyroid gland (PTG) to increase 1α-hydroxylase activity and results in increase intra-gland 1,25D production that attenuates PTH secretion efficiently if sufficient 25D are available. Interesting, calcimimetics can further increase PTG 1α-hydroxylase activity that emphasizes the demand for nutritional vitamin D (NVD) under high PTH status. In addition, the changes in hydroxylase enzyme activity highlight the greater parathyroid 25-hydroxyvitmain D (25D) requirement in secondary hyperparathyroidism (SHPT); the higher proportion of oxyphil cells as hyperplastic parathyroid progression; lower cytosolic vitamin D binding protein (DBP) content in the oxyphil cell; and calcitriol promote vitamin D degradation are all possible reasons supports nutritional vitamin D (NVD; e.g., Cholecalciferol) supplement is crucial in SHPT. Clinically, NVD can effectively restore serum 25D concentration and prevent the further increase in PTH level. Therefore, NVD might have the benefit of alleviating the development of SHPT in early CKD and further lowering PTH in moderate to severe SHPT in dialysis patients. View Full-Text
Keywords: calcitriol; calcimimetics; nutritional vitamin D; secondary hyperparathyroidism calcitriol; calcimimetics; nutritional vitamin D; secondary hyperparathyroidism
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Lu, C.-L.; Yeih, D.-F.; Hou, Y.-C.; Jow, G.-M.; Li, Z.-Y.; Liu, W.-C.; Zheng, C.-M.; Lin, Y.-F.; Shyu, J.-F.; Chen, R.; Huang, C.-Y.; Lu, K.-C. The Emerging Role of Nutritional Vitamin D in Secondary Hyperparathyroidism in CKD. Nutrients 2018, 10, 1890.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Nutrients EISSN 2072-6643 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top