Vitamin D and diabetic nephropathy

Curr Diab Rep. 2008 Dec;8(6):464-9. doi: 10.1007/s11892-008-0080-4.

Abstract

Diabetic nephropathy (DN) is the most common renal complication of diabetes mellitus and a leading cause of end-stage renal disease. The renin-angiotensin system (RAS) is a major mediator of progressive renal injury in DN, and RAS inhibitors have been used as the mainstay treatment for DN. One major problem limiting the efficacy of the RAS inhibitors is the compensatory renin increase caused by disruption of renin feedback inhibition. Vitamin D negatively regulates the RAS by suppressing renin expression and thus plays a renoprotective role in DN. Diabetic vitamin D receptor-null mutant mice develop more severe renal injuries because of more robust RAS activation. Combination therapy with an RAS inhibitor and a vitamin D analogue markedly ameliorates renal injuries due to blockade of the compensatory renin increase by the analogue. These most recent data demonstrate that vitamin D and its analogues have renoprotective and therapeutic potentials in DN through targeting the RAS.

Publication types

  • Review

MeSH terms

  • Animals
  • Diabetic Nephropathies / drug therapy*
  • Diabetic Nephropathies / pathology
  • Diabetic Nephropathies / physiopathology
  • Humans
  • Kidney Diseases / drug therapy
  • Kidney Diseases / pathology
  • Kidney Diseases / physiopathology
  • Renin-Angiotensin System / drug effects
  • Renin-Angiotensin System / physiology
  • Vitamin D / therapeutic use*
  • Vitamins / therapeutic use

Substances

  • Vitamins
  • Vitamin D