Effect of vitamin D supplementation on endothelial dysfunction in hemodialysis patients.

Karakas Y., ŞAHİN G., Urfali F. E., BAL C., Akcar Degirmenci N., SIRMAGÜL B.

Hemodialysis international. International Symposium on Home Hemodialysis, cilt.21, sa.1, ss.97-106, 2017 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 21 Sayı: 1
  • Basım Tarihi: 2017
  • Doi Numarası: 10.1111/hdi.12439
  • Dergi Adı: Hemodialysis international. International Symposium on Home Hemodialysis
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.97-106
  • Anahtar Kelimeler: 25-Hydroxyvitamin D3, carotid intima-media thickness, cholecalciferol, endothelial dysfunction, flow-mediated dilatation, CHRONIC KIDNEY-DISEASE, CHRONIC-RENAL-FAILURE, PERITONEAL-DIALYSIS PATIENTS, D DEFICIENCY, CARDIOVASCULAR-DISEASE, DEPENDENT VASODILATATION, BRACHIAL-ARTERY, MEDIA THICKNESS, RISK, ATHEROSCLEROSIS
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

Introduction: Patients with chronic kidney disease (CKD) commonly experience 25-hydroxyvitamin D3 (25-OH-D3) deficiency, and these patients have a higher incidence of cardiovascular diseases (CVDs) due to endothelial dysfunction (ED). The aim of our study was to investigate the effect of 25-OH-D3 deficiency and its supplementation on ED in patients with CKD. Methods: Twenty-nine uremic patients on dialysis and 20 healthy controls were evaluated for ED by high-resolution Doppler ultrasonography of the brachial artery. In addition, 25-OH-D3-deficient patients (25-OH-D3 < 30 nmol/L) with CKD and healthy controls were evaluated for ED before and after 8 weeks of oral vitamin D (cholecalciferol, 50,000 units) treatment. All subjects were evaluated for percent flow-mediated dilatation (% FMD), percent endothelium-independent nitroglycerin-induced vasodilatation (% NID), and bilateral carotid intima-media thickness (CIMT). Findings: Patients on dialysis had lower % FMD and % NID 6.11 [2.27-12.74] and 10.96 [5.43-16.4], respectively, than controls 15.84 [8.19-22.49] and 21.74 [12.49-29.4], respectively (P< 0.05). Patients on dialysis had higher left and right CIMT (0.79 +/- 0.15 and 0.78 +/- 0.14, respectively) than controls (0.60 +/- 0.09 and 0.59 +/- 0.09, respectively; P< 0.05). In 25-OH-D3-deficient patients with CKD, after vitamin D treatment, % FMD was significantly increased in dialysis patients (10.25 [7.8-12.8]) compared to before supplementation (5.4 [2.77-6.15]; P< 0.001). Discussion: These results indicated that dialysis patients had significantly lower blood 25-OH-D3 levels and higher CIMT than healthy subjects. In addition, vitamin D supplementation improved ED and increased % FMD in dialysis patients. Our findings suggest that vitamin D supplementation in dialysis patients might prevent CVD.