VITAMIN D IN HEALTH AND DISEASE: Vitamin D for Health and in Chronic Kidney Disease

Abstract

Vitamin D is taken for granted and is not appreciated for its importance in overall health and well‐being. Vitamin D, known as the sunshine vitamin, is appreciated as being important for the prevention of rickets in children. It is now recognized that vitamin D is important for not only the growing skeleton, but for the maintenance of a healthy musculoskeletal system throughout life. Vitamin D deficiency in adults precipitates and exacerbates osteoporosis and causes the painful bone disease osteomalacia. The revelation that vitamin D is biologically inactive and requires sequential hydroxylations in the liver and kidney to form 1,25‐dihydroxyvitamin D helps explain why patients with renal failure are often resistant to vitamin D and suffer from secondary hyperparathyroidism and renal osteodystrophy. In addition to its role in maintaining calcium and phosphorus homeostasis, vitamin D is now being recognized as important for maintaining maximum muscle strength and for the prevention of many chronic diseases, including type I diabetes, multiple sclerosis, rheumatoid arthritis, hypertension, cardiovascular heart disease, and many common cancers. Vitamin D status is best determined by the measurement of circulating levels of 25‐hydroxyvitamin D. Vigilance for maintaining a 25‐hydroxyvitamin D level of at least 20 ng/ml and preferably 30–50 ng/ml has important benefits for both healthy children and adults, as well as children and adults suffering from chronic kidney disease.