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首页> 外文期刊>International Journal of Environmental Research and Public Health >Vitamin D Deficiency in Chronic Kidney Disease: Recent Evidence and Controversies
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Vitamin D Deficiency in Chronic Kidney Disease: Recent Evidence and Controversies

机译：慢性肾脏病中维生素D缺乏症的最新证据和争议

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Vitamin D (VD) is a pro-hormone essential for life in higher animals. It is present in few types of foods and is produced endogenously in the skin by a photochemical reaction. The final step of VD activation occurs in the kidneys involving a second hydroxylation reaction to generate the biologically active metabolite 1,25(OH) 2 -VD. Extrarenal 1α-hydroxylation has also been described to have an important role in autocrine and paracrine signaling. Vitamin D deficiency (VDD) has been in the spotlight as a major public healthcare issue with an estimated prevalence of more than a billion people worldwide. Among individuals with chronic kidney disease (CKD), VDD prevalence has been reported to be as high as 80%. Classically, VD plays a pivotal role in calcium and phosphorus homeostasis. Nevertheless, there is a growing body of evidence supporting the importance of VD in many vital non-skeletal biological processes such as endothelial function, renin-angiotensin-aldosterone system modulation, redox balance and innate and adaptive immunity. In individuals with CKD, VDD has been associated with albuminuria, faster progression of kidney disease and increased all-cause mortality. Recent guidelines support VD supplementation in CKD based on extrapolation from cohorts conducted in the general population. In this review, we discuss new insights on the multifactorial pathophysiology of VDD in CKD as well as how it may negatively modulate different organs and systems. We also critically review the latest evidence and controversies of VD monitoring and supplementation in CKD patients.
机译：维生素D（VD）是高等动物生命所必需的促激素。它存在于几种类型的食品中，是通过光化学反应在皮肤内源性产生的。 VD活化的最后一步发生在肾脏中，该肾脏参与第二次羟基化反应以生成生物活性代谢物1,25（OH）2 -VD。还已经描述了肾外1α-羟基化在自分泌和旁分泌信号传导中具有重要作用。维生素D缺乏症（VDD）已成为主要的公共卫生保健问题，在全球范围内估计有10亿以上的患病率。在患有慢性肾脏病（CKD）的个体中，据报道VDD患病率高达80％。典型地，VD在钙和磷的动态平衡中起关键作用。然而，越来越多的证据支持VD在许多重要的非骨骼生物学过程中的重要性，例如内皮功能，肾素-血管紧张素-醛固酮系统调节，氧化还原平衡以及先天和适应性免疫。在患有CKD的个体中，VDD与蛋白尿，肾脏疾病进展更快和全因死亡率增加有关。最近的指南基于对一般人群进行的队列推算，支持在CKD中补充VD。在这篇综述中，我们讨论了CKD中VDD的多因素病理生理学的新见解，以及它如何负面调节不同器官和系统。我们还严格审查了CKD患者VD监测和补充的最新证据和争议。

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