25 oh vit d therapy in ckd

Vitamin D in CKD

1. 25-OH Vit D therapy in CKD stage 2-5 Dr Dhanin.P 27/9/17

2. Introduction Two major forms Ergocalciferol ( vit D2) and Cholecalciferol (D3) 25 (OH) D : major biomarker of total vit D store Vit D binding protein Vit D receptor Fat soluble vitamin

3. Guidelines for 25 OH Vit D In 1976, Eastwood et al showed low levels of 25(OH)D in patients with both CKD In 1975,Chertow et al discovered that administration of the Active vit D reduces PTH secretion in rats. 2003 KDOQI clinical practice guideline:

4. KDIGO CKD-MBD 2017 CKD G3-5 : optimal PTH unknown Native vit D supplementation as previously Calcitriol & vit D analogues not routinely are recommended

5. Threshold for treatment 30 ng/dl Sufficient; insufficient; deficient On the basis of maximal PTH suppression Depends on the Ca intake Ehnicity

6. Non bone disease indication 1 α hydroxylase : Placenta , GI tract, skin , blood vessels , and granulomatous tissue Subtle vit D deficiency : Risk for hypertension, obesity , diabetes, cardiovascular diseases, autoimmune diseases , asthma, and depression Presence of vit D receptors NKF-KDOQI and KDIGO guidelines did not recommend supplementing 25(OH)D for non–bone- related chronic diseases in patients with CKD

7. Conclusion Measure Monitor Target Preparation Toxicity