The Protective Role Of Active Vitamin D Supplement On Chronic Kidney Disease Patients:a Meta-analysis

Objectivevitamin D deficiency is prevalence in patients with chronic kidney disease. Vitamin Dsupplementation have a good effect on chronic kidney disease with secondaryhyperparathyroidism in patients, but whether vitamin D supplementation have effects onpatients without secondary hyperparathyroidism in chronic kidney disease.MethodsI searched published journals and electronic journal literatures about the RCTs of vitamin Dsupplementation on chronic kidney disease, contains to CMCC, CNKI, PubMed, Medline,EMBase, Chinese Medical Association digitized journals, wan-fang digitized text database,VIP Chinese database and manual search. Literatures that match the inclusion criteria formeta-analysis use the Mantel-Haenszel method to calculate the RR value.ResultsThere were8selected literatures, including903cases, of which481patients were inexperimental group and422patients were in control group. For8literatures,4articles aredescribed on proteinuria,3articles on PTH,4articles on the incidence of hypercalcemiaduring the treatment period,4articles on the incidence of side effects, and2articles on theincidence of cardiovascular events. Compared with control group, after vitamin D supplementation proteinuria was declined by25.9%[RR合并＝1.82，95％CI（1.31，2.54）,P2=0.0004] in experimental group; the incidence of hypercalcemia was increased by8.4%in experimental group [RR合并＝8.23,95％CI（2.74,24.72），P2=0.0002]; theincidence of cardiovascular events was declined by4.9%[RR合并＝0.40,95％CI（0.23,0.69）, P2=0.0009];serum PTH levels is declined20.92pg/ml compared with baselinevalues[MD合并＝-20.92，95％CI（-29.56,-12.28），P2＜0.00001].The occurrence ofsideeffects compared with control group was not statistically signification.ConclusionVitamin D supplementation can reduce proteinuria, reduce PTH, while reducing theincidence of cardiovascular events, but it also increases the risk of hypercalcemia. Thedose less than1ug of calcitriol is a safe dose, and it has an increased occurrence of sideeffects and hypercalcemia if increasing the dose.