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Vitamin D deficiency associates with mortality in patients with CKD, and vitamin D supplementation might mitigate cardiovascular disease risk in CKD. In this randomized, double-blind, placebo-controlled trial, we investigated the effect of cholecalciferol supplementation on vascular function in 120 patients of either sex, aged 18-70 years, with nondiabetic CKD stage 3-4 and vitamin D deficiency (serum 25-hydroxyvitamin D ≤20 ng/ml). We randomized patients using a 1:1 ratio to receive either two directly observed oral doses of cholecalciferol (300,000 IU) or matching placebo at baseline and 8 weeks. The primary outcome was change in endothelium-dependent brachial artery flow-mediated dilation at 16 weeks. Secondary outcome measures included changes in pulse wave velocity and circulating biomarkers. Cholecalciferol supplementation significantly increased endothelium-dependent brachial artery flow-mediated dilation at 16 weeks, whereas placebo did not (between-group difference in mean change: 5.49%; 95% confidence interval, 4.34% to 6.64%; P<0.001). Intervention also led to significant favorable changes in pulse wave velocity and circulating IL-6 levels. Thus, in nondiabetic patients with stage 3-4 CKD and vitamin D deficiency, vitamin D supplementation may improve vascular function. This study is registered with the Clinical Trials Registry of India (no.: CTRI/2013/05/003648).

Original publication

DOI

10.1681/ASN.2017010003

Type

Journal article

Journal

J Am Soc Nephrol

Publication Date

10/2017

Volume

28

Pages

3100 - 3108

Keywords

Vitamin D, cardiovascular disease, chronic kidney disease, Adult, Biomarkers, C-Reactive Protein, Cardiovascular Diseases, Dietary Supplements, Endothelium, Vascular, Female, Humans, Interleukin-6, Male, Middle Aged, Pulse Wave Analysis, Renal Insufficiency, Chronic, Vascular Stiffness, Vasodilation, Vitamin D, Vitamins