Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2017, Article ID 2803579, 13 pages
https://doi.org/10.1155/2017/2803579
Review Article

Role of Vitamin D in Uremic Vascular Calcification

1Division of Nephrology, Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
2Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
3Division of Nephrology, Department of Internal Medicine, Yonghe Cardinal Tien Hospital, New Taipei City, Taiwan
4Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
5Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
6Division of Critical Care Medicine, Department of Emergency Medicine-Critical Care Medicine (EM-CCM), Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
7Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
8Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Correspondence should be addressed to Kuo-Cheng Lu; moc.liamg@ulgnehcouk

Received 1 November 2016; Revised 26 December 2016; Accepted 16 January 2017; Published 12 February 2017

Academic Editor: Xiong-Zhong Ruan

Copyright © 2017 Yi-Chou Hou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The risk of cardiovascular death is 10 times higher in patients with CKD (chronic kidney disease) than in those without CKD. Vascular calcification, common in patients with CKD, is a predictor of cardiovascular mortality. Vitamin D deficiency, another complication of CKD, is associated with vascular calcification in patients with CKD. GFR decline, proteinuria, tubulointerstitial injury, and the therapeutic dose of active form vitamin D aggravate vitamin D deficiency and reduce its pleiotropic effect on the cardiovascular system. Vitamin D supplement for CKD patients provides a protective role in vascular calcification on the endothelium by (1) renin-angiotensin-aldosterone system inactivation, (2) alleviating insulin resistance, (3) reduction of cholesterol and inhibition of foam cell and cholesterol efflux in macrophages, and (4) modulating vascular regeneration. For the arterial calcification, vitamin D supplement provides adjunctive role in regressing proteinuria, reverse renal osteodystrophy, and restoring calcification inhibitors. Recently, adventitial progenitor cell has been linked to be involved in the vascular calcification. Vitamin D may provide a role in modulating adventitial progenitor cells. In summary, vitamin D supplement may provide an ancillary role for ameliorating uremic vascular calcification.