D Vitamini ve Kronik Böbrek Hastalıkları ile İlişkisi

Yıl 2021, Cilt: 4 Sayı: 1, 49 - 60, 18.09.2021

Çiğdem Ayvaz Nimetcan Mehmet

Öz

D vitamini, insan sağlığı için önemli etkileri olan temel bir mikro besin maddesidir. Vücutta birçok sistemi etkileyen D vitamini eksikliğinin prevalansı oldukça yüksektir. D vitamini eksikliği veya yetersizliği Dünyada yaklaşık olarak bir milyar insanda vardır. D vitamininin kaynaklarına bakıldığında, esas kaynağı, güneş ışığına maruz kalmaktır. D vitaminini doğal olarak içeren çok az besin vardır, ek olarak bazı gıdalar bu vitaminle güçlendirilmiştir. Bu yüzden, D vitamini eksikliğinin asıl sebebi yetersiz güneş ışığı maruziyetidir. Bu vitamin temel olarak kemik fizyolojisinde önemli bir besin öğesi olarak düşünülse de, endokrin, kardiyovasküler ve bağışıklık sistemleri de dahil olmak üzere diğer organ sistemlerinin optimal işleyişinin merkezinde yer alır. Hafif ve orta şiddette D vitamini eksikliği otoimmün hastalıklar, hipertansiyon, sık görülen kanserler, enfeksiyöz hastalıklar, diyabet ve kalp yetmezliği ile ilişkili bulunmuştur. Bu vitaminin eksikliği hem genel popülasyonda hem de özellikle Kronik Böbrek Yetmezliği (KBY) olan hastalarda dünya çapında bir sağlık sorunu haline gelmektedir. Birçok gözlemsel araştırma, D vitamini eksikliği ile bozulmuş glomerüler filtrasyon hızı (GFR) ve KBY'li hastalarda artmış mortalite arasında önemli bir ilişki olduğunu ortaya koymuştur. Bu derlemenin amacı, D vitaminin kaynakları, yeterlilik düzeyi, hastalıklarla olan ilişkisi gibi konular hakkında bilgi vermek ve Kronik Böbrek Yetmezliği olan hastalarda D vitamini metabolizmasındaki değişiklikleri saptamak ve bu değişiklikleri önlemek amacıyla yapılan çalışma sonuçlarını ortaya koymaktır.

Anahtar Kelimeler

D Vitamini, D Vitamini Eksikliği, Kronik Böbrek Yetmezliği

Destekleyen Kurum

-

Proje Numarası

-

Teşekkür

-

Relationship between Vitamin D and chronic kidney disease

Öz

Vitamin D is an essential micronutrient that has important effects on human health. The prevalence of vitamin D deficiency is very high that affects many systems in the body. Approximately one billion people around the world have a vitamin D deficiency or insufficiency. Looking at the sources of vitamin D, sunlight is the main source of the vitamin D. There are very few foods that naturally contain vitamin D, in addition, some foods are fortified with this vitamin. Thus, insufficient sunlight exposure is the main cause of vitamin D deficiency. Although this vitamin is primarily considered an important nutrient in bone physiology, it is at the center of the optimal functioning of other organ systems, including the endocrine, cardiovascular and immune systems. Mild and moderate vitamin D deficiency has been associated with autoimmune diseases, hypertension, common cancers, infectious diseases, diabetes, and heart failure. Deficiency of this vitamin is becoming a worldwide health problem both in the general population and especially in patients with Chronic Renal Failure (CRF). Many observational studies have revealed a significant association between vitamin D deficiency and impaired glomerular filtration rate (GFR) and increased mortality in patients with CRF. The purpose of this review is to provide information about the sources of vitamin D, level of competence, its relationship with diseases, and to explore the findings of studies on relationship between vitamin D patients with CRF.

Anahtar Kelimeler

Vitamin D, Chronic Renal Failure, Vitamin D Deficiency

Proje Numarası

-

Kaynakça

• Referans1. Ravani, P., Malberti, F., Tripepi, G., Pecchini, P., Cutrupi, S., Pizzini, P., ... & Zoccali, C., Vitamin D levels and patient outcome in chronic kidney disease. Kidney international, 2009: 75(1), 88-95.
• Referans2. Yıldıran, H., & Ayyıldız, F., D Vitamini ve Depresyon. Turkiye Klinikleri Nutrition and Dietetics-Special Topics, (2019): 5(3), 59-63.
• Referans3. Kandula, P., Dobre, M., Schold, J. D., Schreiber, M. J., Mehrotra, R., & Navaneethan, S. D., Vitamin D supplementation in chronic kidney disease: a systematic review and meta-analysis of observational studies and randomized controlled trials. Clinical Journal of the American Society of Nephrology 2011: 6(1), 50-62.
• Referans4. Holick, M. F., Vitamin D deficiency. New England Journal of Medicine, 2007: 357(3), 266-281.
• Referans5. Kim, C. S., & Kim, S. W., Vitamin D and chronic kidney disease. The Korean journal of internal medicine, 2014: 29(4), 416-427.
• Referans6. Wolf, M., Shah, A., Gutierrez, O., Ankers, E., Monroy, M., Tamez, H., ... & Thadhani, R., Vitamin D levels and early mortality among incident hemodialysis patients. Kidney international, 2007: 72(8), 1004-1013.
• Referans7. Holick, M. F., & Chen, T. C., Vitamin D deficiency: a worldwide problem with health consequences. The American journal of clinical nutrition, 2008: 87(4), 1080S-1086S.
• Referans8. Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., ... & Weaver, C. M., Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 2011: 96(7), 1911-1930.
• Referans9. Wacker, M., & Holick, M. F., Vitamin D—effects on skeletal and extraskeletal health and the need for supplementation. Nutrients, 2013: 5(1), 111-148.
• Referans10. Holick, M. F., Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. The American journal of clinical nutrition, 2004: 80(6), 1678S-1688S.
• Referans11. Bikle, D., Nonclassic actions of vitamin D. The Journal of Clinical Endocrinology & Metabolism, 2009: 94(1), 26-34.
• Referans12. Artaza, J. N., Mehrotra, R., & Norris, K. C., Vitamin D and the cardiovascular system. Clinical Journal of the American Society of Nephrology, 2009: 4(9), 1515-1522.
• Referans13. Wang, T. J., Pencina, M. J., Booth, S. L., Jacques, P. F., Ingelsson, E., Lanier, K., ... & Vasan, R. S., Vitamin D deficiency and risk of cardiovascular disease. Circulation, 2008: 117(4), 503-511.
• Referans14. Coussens, A. K., The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease. Photochemical & Photobiological Sciences, (2017): 16(3), 314-338.
• Referans15. Kearns, M. D., Alvarez, J. A., Seidel, N., & Tangpricha, V., Impact of vitamin D on infectious disease. The American journal of the medical sciences, (2015): 349(3), 245-262.
• Referans16. Walsh, J. S., Bowles, S., & Evans, A. L., Vitamin D in obesity. Current Opinion in Endocrinology & Diabetes and Obesity, (2017): 24(6), 389-394.
• Referans17. Pereira‐Santos, M., Costa, P.R.D.F., Assis, A.M.O.D., Santos, C.A.D.S.T., & Santos, D.B. D., Obesity and vitamin D deficiency: a systematic review and meta‐analysis. Obesity reviews, (2015): 16(4), 341-349.
• Referans18. Vanlint, S., Vitamin D and obesity. Nutrients, 2013: 5(3), 949-956.
• Referans19. Przybelski, R. J., & Binkley, N. C., Is vitamin D important for preserving cognition? A positive correlation of serum 25-hydroxyvitamin D concentration with cognitive function. Archives of Biochemistry and Biophysics, 2007: 460(2), 202-205.
• Referans20. Atkins, R. C., The epidemiology of chronic kidney disease. Kidney International, 2005: 67, S14-S18.
• Referans21. James, M. T., Hemmelgarn, B. R., & Tonelli, M., Early recognition and prevention of chronic kidney disease. The Lancet, 2010: 375(9722), 1296-1309.
• Referans22. Mizobuchi, M., Finch, J. L., Martin, D. R., & Slatopolsky, E., Differential effects of vitamin D receptor activators on vascular calcification in uremic rats. Kidney international, 2007: 72(6), 709-715.
• Referans23. Holick, M. F., VITAMIN D IN HEALTH AND DISEASE: Vitamin D for Health and in Chronic Kidney Disease. In Seminars in dialysis 2005: (Vol. 18, No. 4, pp. 266-275). Blackwell Science Inc.
• Referans24. Al-Badr, W., & Martin, K. J., Vitamin D and kidney disease. Clinical Journal of the American Society of Nephrology, 2008: 3(5), 1555-1560.
• Referans25. Levin, A., Bakris, G. L., Molitch, M., Smulders, M., Tian, J., Williams, L. A., & Andress, D. L., Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney international, 2007: 71(1), 31-38.
• Referans26. Thadhani, R., Appelbaum, E., Pritchett, Y., Chang, Y., Wenger, J., Tamez, H., ... & Lloyd-Jones, D., Vitamin D therapy and cardiac structure and function in patients with chronic kidney disease: the PRIMO randomized controlled trial. Jama, 2012: 307(7), 674-684.
• Referans27. El Nahas, A. M., & Bello, A. K., Chronic kidney disease: the global challenge. The Lancet, 2005: 365(9456), 331-340.
• Referans28. Kim, H. S., Chung, W., & Kim, S., Vitamin d, and kidney disease. Electrolytes & Blood Pressure, 2011: 9(1), 1-6.