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논문분류	춘계학술대회 초록집
제목	Vitamin D deficiency accentuate anti-proteinuria effect of calcitriol in Patients with Chronic Kidney Disease: A Randomized Controlled Trial
저자	Min-Tser Liao, Chien-Lin Lu, Chia-Chao Wu, Yu-Juei Hsu, Kuo-Cheng Lu, Pauling Chu
출판정보	2019; 2019(1):
키워드	Chronic kidney disease \| proteinuria \| vitamin D
초록	Vitamin D had shown efficacy in the reduction of proteinuria in patients with chronic kidney disease. This study aimed to determine the effect of low dose oral calcitriol (0.25μg, 3 times per week) on urinary protein excretion in patients with chronic kidney disease and vitamin D deficiency. Sixty patients with chronic kidney disease (CKD) with an estimated GFR > 15 ml/min, and were on a stable dose of an angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) were studied for 24 weeks. Patients were randomly allocated to 2 groups. Group I received oral vitamin D (calcitriol) 0.25 mcg three times per week. Patients were followed up every 8 weeks. Urine protein/creatinine ratio (uPCR) was measured and blood was drawn for biochemistry tests before the study and during each follow-up visit There was no significant difference in baseline uPCR between control and vitamin D treatment groups. UPCR decreased significantly at 8 weeks, 16 weeks and 24 weeks (p < 0.05 vs. baseline) in vitamin D treatment group. In addition, uPCR were significantly lower in vitamin D treatment group than in control group at week 8, 16 and 24 (p <0.05). There was positive correlation between reduction of uPCRs at 24 weeks and the baseline serum level of 25-(OH) D in the vitamin D treatment group (r = 0.738, p < 0.001). There was no significant difference in blood pressure, serum creatinine, eGFR, glucose, ionized calcium and phosphorus between control and vitamin D treatment groups during follow-up. Low dose Calcitriol administration in addition to stable RAAS inhibitiors led to a significant reduction in proteinuria in patients with CKD and vitamin D deficiency. Patients with lower baseline serum 25-(OH) D have a higher reduction of uPCR in the vitamin-D treatment group which is independent of BP and renal function change.
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