Abstract 13739: 16-Week Vitamin D Therapy Improves Endothelial Function and Does Not Change Arterial Stiffness in Chronic Kidney Disease Patients
Background: We have previously demonstrated abnormal endothelial function in patients with Chronic Kidney Disease (CKD) and its association with Vitamin D deficiency. However the impact of Vitamin D therapy on endothelial function and arterial stiffness is unknown.
Methods: This study aimed to investigate the effect of 25(OH) Vitamin D supplementation on endothelial function and arterial stiffness in patients with CKD stages 3/4 over 16 weeks. The study was approved by NHS Research Ethics Committee. The endothelial function was measured with post-ischaemic brachial artery flow mediated dilatation at a fasting state by trained staff using a method previously established in our laboratory. The central artery stiffness was measured with pulse wave velocity using SphygmoCor machine. Vitamin D was supplemented with 2 doses of 300,000 units of Cholecalciferol (Martindale) at baseline and 8 weeks.
Results: Twenty-one stable CKD patients with Vitamin D <75 nmol/L; and without diabetes, heart failure, infection, malignancy, autoimmune disease, CRP>20 mg/L, hypercalcaemia, recent myocardial infarction or stroke; were enrolled. At baseline the clinical characteristics were; age 52±14 (mean±SD) years, females 33%, Southeast Asian 24%, Afro Caribbean 24%, dyslipidaemia 43%, smokers 24%, BMI 29±5 kg/m2, systolic BP 133±13 mmHg, diastolic BP 86±9 mmHg, eGFR 38±11 ml/min/1.73m2, haemoglobin 13.7±1.4 g/dl, vitamin D 45±15 nmol/L, calcium 2.37±0.1 mmol/L, phosphate 1.1±0.2 mmol/L, parathyroid hormone 11.6±9.1 pmol/L. With treatment the vitamin D level increased (45±15 to 79±29 nmol/L; p<0.001), calcium increased (2.37±0.09 to 2.43±0.09 mmol/L; p=0.001), parathyroid hormone decreased (11.6±9.1 to 7.5±2.4 pmol/L;p=0.008). No patients developed hypercalcaemia. Serum phosphate, eGFR levels remained unchanged. Endothelial function improved (2.80±3.87 to 5.59±2.89 %; p<0.004). The pulse wave velocity remained the same (7.9±1.3 and 7.8±2.2 m/s; p=0.78).
Conclusion: This study, for the first time demonstrates improvement of endothelial function with 16 week 25 (OH) Vitamin D therapy without any adverse effect on arterial stiffness in patients with moderate CKD.
- © 2012 by American Heart Association, Inc.