"There is mounting evidence of the benefits of correcting vitamin D levels to prevent or delay the development of albuminuria in the general population," said the study's lead researcher,
"Multiple observational studies suggest an important role of vitamin D in patients with CKD and ESRD and potentially in the general population. There are potentially different roles for nutritional and active vitamin D compounds (Table 3). Nutritional vitamin D may play more of a role in infections, whereas active vitamin D compounds may play more of a role in albuminuria and mortality. Both nutritional and active vitamin D eventually affect the same vitamin D receptor; however, nutritional vitamin D has to undergo additional activation in the body, potentially at sites distant from the kidney."
This review discusses observational and available clinical trial evidence about the effects of both calcitriol and vitamin D analogs (active) and ergocalciferol and cholecalciferol (nutritional) vitamin D in patients with CKD and ESRD.
"Primary care physicians are called to join the intensified efforts of nephrologists, endocrinologists, nutritionists, other specialists and public health agencies to disseminate and implement updated guidelines and recommendations to halt the growing epidemic of vitamin D deficiency, particularly in the highly susceptible CKD population. The results of emerging studies may herald novel agents, which may further modulate these vitamin D-related cell signaling pathways and contribute to many of the co-morbidities encountered in the CKD patient deficient in vitamin D."