Vitamin D Status in Chronic Kidney Disease - UVB Irradiation Is Superior to Oral Supplementation

作者：Krause Rolfdieter^*; Roth Heinz Juergen; Kaase Heinrich; Stange Rainer; Holick Michael F

来源：Anticancer Research, 2016, 36(3): 1397-1401.

• Vitamin D
• oral supplementation
• UVB irradiation
• extra-renal synthesis
• 25-hydroxyvitamin D
• 1-alpha-hydroxylase
• 1,25-dihydroxyvitamin D
• vitamin D receptor
• chronic kidney disease (CKD)
• dialysis (ESKD)

Background: In chronic kidney disease (CKD) a deficiency of 1,25-dihydroxyvitamin D is common. The aim of this review was to compare vitamin D status after oral supplementation of vitamin D-3 to that of serial suberythemal irradiation in end-stage kidney disease (ESKD) patients. Patients and Methods: Ninety-five patients, with a mean age of 62 (range=35-82) years, were treated with a mean dose of 35,000 (20,000-60,000) IU vitamin D-3 per week for a period of 18 months. Fourteen patients, with a mean age of 51 (range=41-57) years, were whole-body UVB irradiated for over 6 months. From 3 hemodialysis patients skin biopsies were performed. Results: With oral supplementation 25(OH)D-3 increased by 60%. With UV irradiation 25(OH)D-3 increased by 400%. Gene expression analysis demonstrated an improvement in the vitamin D receptor (VDR) by 0.65 fold, in 1-alpha-hydroxylase (CYP27B1) by 1.0 fold, and in 25-hydroxylase (CYP2R) by 1.2 fold. Conclusion: Serial suberythemal UVB irradiation of patients with CKD on dialysis is capable to improve serum 25(OH)D-3 and 1,25(OH)(2)D-3 by enhancing the skin's ability to activate vitamin D.

• 出版日期2016-3