DENVER—Vitamin D supplementation may improve biochemical end points in CKD patients, but whether such improvements translate into clinically significant outcomes is still unknown, according to a systematic review and meta-analysis.

Praveen Kandula, MD, of Southern Illinois University School of Medicine in Springfield, and colleagues reported that vitamin D supplementation may be appropriate in CKD but studies have yet to show any clinical benefit. The researchers assessed the potential benefits and harms of vitamin D supplementation (ergocalciferol or cholecalciferol) in CKD patients. The authors searched MEDLINE (1966- September 2009), SCOPUS (September 2009), and nephrology conference proceedings for relevant observational and randomized controlled trials (RCTs). Separate analyses were conducted for RCTs and observational studies.  A total of 22 studies (17 observational and 5 RCTs) were included.

From the observational studies, the researchers found significant improvement in 25-hydroxyvitamin D (25D), 1,25-hydroxyvitamin D (1,25D) levels, and an associated decline in parathyroid hormone (PTH) levels. Among RCTs, the study revealed significant improvements in 25D and an associated decline in PTH levels, but no significant change in 1,25 D levels. 

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The meta-analysis revealed low incidences of hypercalcemia and hyperphosphatemia with vitamin D supplementation.