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Cited by 60Chronic Kidney Disease and DiabetesVitamin D Research StudiesDialysis and Renal Disease Management

Effects of Vitamin D Supplementation on Renal Function, Inflammation and Glycemic Control in Patients with Diabetic Nephropathy: a Systematic Review and Meta-Analysis

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Wang, Yangyang, Yang, Shikun, Zhou, Qianying, Zhang, Hao, Yi, Bin·2019·Kidney and Blood Pressure Research
DOI 10.1159/000498838
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Abstract

Background/Aims: Vitamin D (VD) is widely recognized as renal protective. However, whether VD supplementation provides benefit to patients with diabetic nephropathy (DN) remains controversial. Here, we performed a meta-analysis to systematically evaluate the impact of VD supplementation on indexes of renal function, inflammation and glycemic control in DN patients, and to explore the potential renal protective mechanism of VD. Methods: We searched Pubmed, Embase, Cochrane Library, and three major Chinese biomedical databases (CNKI, WANGFANG and VIP) for randomized controlled trials (RCTs) examining the effects of VD or its analogs in DN patients, published between September 2007 and July 2018. Quality assessment and data extraction were performed independently by two authors, according to the Cochrane systematic review methods. Meta-analysis based on the extracted results were performed via Revman 5.2 software. Results: We included 20 RCTs representing 1,464 patients with DN in this meta-analysis. VD supplementation significantly reduced 24-hour urine protein [MD = -0.26; 95% CI (-0.34, -0.17); P < 0.00001; I 2 = 95%], UAER [MD = -67.36; 95% CI (-91.96, -42.76); P < 0.00001; I 2 = 97%], hs-CRP [MD = -0.69; 95% CI (-0.86,-0.53); P < 0.00001; I 2 = 0%], TNF-α [MD = -56.79; 95% CI (-77.05, -36.52); P < 0.00001; I 2 = 89%] and IL-6 [MD = -0.73; 95% CI(-1.03, -0.44); P < 0.00001; I 2 = 0%]. However, VD supplementation failed to decrease SCr [MD = -0.83; 95% CI (-3.67,2.02); P = 0.57; I 2 = 0%] or increase eGFR [MD = 2.13; 95% CI (-2.06, 6.32); P = 0.32; I 2 = 0%]. In addition, VD supplementation showed no impact on indexes of glycemic control, such as HbA1c [MD = 0.01; 95% CI (-0.09, 0.11); P = 0.84; I 2 = 0%] and FBG [MD = -0.05; 95% CI (-0.29, 0.20); P = 0.70; I 2 = 0%]. Analysis of 24-hour urine protein, SCr, eGFR, hs-CRP or HbA1c revealed no difference between subgroups based on the type of VD supplementation, including calcitriol, alfacalcidol and vitamin D3, and the dose or duration of calcitriol usage. Conclusion: In patients with DN, VD supplementation provides beneficial effects on 24-hour urine protein and inflammation indexes, but not on SCr, eGFR or glycemic control indexes. More RCTs that comprehensively evaluate the impact of VD supplementation on indexes of renal function, inflammation and glycemic control in DN atients are required in order to reach conclusive results.

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Cited by

Sorted by citations

Authors
Wang, Y., Yang, S., Zhou, Q., Zhang, H., & Yi, B.
Affiliations
Central South University (CN)
ORCID
Venue
Kidney and Blood Pressure Research
Publisher
S. Karger AG
Published
2019
Volume
44
Issue
1
Pages
72-87
ISSN
  • 1420-4096 (ISSN-L)
  • 1423-0143
DOI
10.1159/000498838
OpenAlex
W2916600582
Cited by
60
References
2
Citations by year
2026: 2 · 2025: 8 · 2024: 7 · 2023: 14 · 2022: 13 · 2021: 6 · 2020: 8 · 2019: 2
FWCI
1.14
Type
journal article
Language
en
Open access
Licence
Locations
  • Kidney & Blood Pressure Research (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Central South University
  • Xiangya Hospital, Central South University
  • Fundamental Research Funds for the Central Universities
Topics
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Keywords
vitamin D supplementation, diabetic nephropathy, renal function, inflammation, glycemic control, urinary albumin excretion rate, urinary protein, C-reactive protein, TNF-α, interleukin-6, serum creatinine, HbA1c, vitamin D analogs, renal protection, proteinuria, hyperglycemia, insulin resistance, oxidative stress, renin-angiotensin system, renin-angiotensin-aldosterone system, renin-angiotensin system blockade
MeSH terms
Blood Glucose, Diabetic Nephropathies, Humans, Inflammation, Kidney, Vitamin D, Randomized Controlled Trials as Topic, Dietary Supplements

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