Oral cholecalciferol decreases albuminuria and urinary TGF-β1 in patients with type 2 diabetic nephropathy on established renin-angiotensin-aldosterone system inhibition

Kidney Int. 2011 Oct;80(8):851-60. doi: 10.1038/ki.2011.224. Epub 2011 Aug 10.

Abstract

The anti-inflammatory, antifibrotic, and antiproteinuric properties of vitamin D have been defined in studies using active vitamin D analogs. In this prospective observational study we determined whether nutritional vitamin D repletion can have additional beneficial effects in patients with type 2 diabetic nephropathy already established on renin-angiotensin-aldosterone system inhibition. During a 7-month period, 63 patients were enrolled and those with low levels of 25(OH)D were treated with oral cholecalciferol for 4 months. Baseline serum 25(OH)D and 1,25(OH)(2)D showed no significant correlation with baseline urinary MCP-1, TGF-β1, or albuminuria measured as the urinary albumin-to-creatinine ratio. Of the 63 patients, 54 had insufficient or deficient levels of serum 25(OH)D and 49 complied with cholecalciferol therapy and follow-up. Both 25(OH)D and 1,25(OH)(2)D were significantly increased at 2 and 4 months of treatment. Albuminuria and urinary TGF-β1 decreased significantly at both time points compared to their baseline values, while urinary MCP-1 did not change. Thus, in the short term, dietary vitamin D repletion with cholecalciferol had a beneficial effect in delaying the progression of diabetic nephropathy above that due to established renin-angiotensin-aldosterone system inhibition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Albuminuria / drug therapy*
  • Albuminuria / urine
  • Chemokine CCL2 / urine
  • Cholecalciferol / administration & dosage
  • Cholecalciferol / therapeutic use*
  • Creatinine / urine
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Nephropathies / drug therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Renin-Angiotensin System / drug effects*
  • Renin-Angiotensin System / physiology
  • Transforming Growth Factor beta1 / urine*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D-Binding Protein / urine

Substances

  • CCL2 protein, human
  • Chemokine CCL2
  • Transforming Growth Factor beta1
  • Vitamin D-Binding Protein
  • Vitamin D
  • Cholecalciferol
  • 25-hydroxyvitamin D
  • Creatinine