CLINICAL QUERIES: Vitamin D supplementation in chronic kidney disease
Debra Castner MSN, RN, ACPN, CNN

December 2011 
Volume 41  Number 12
Pages 68 - 68
  PDF Version Available!

Debra Castner, MSN, RN, ACPN, CNN, replies: At the point when patients with CKD need renal replacement therapy (dialysis), virtually all of them have mineral and bone disorder (MBD), which includes vitamin D deficiency.1 Vitamin D deficiency in a person with CKD is a complex disorder. Effects of CKD-MBD include proximal myopathy, soft-tissue and vascular calcification, bone disease, and pruritus.2Some experts consider vitamin D a steroid hormone, while others consider it similar to a hormone due to its pathway of molecular activation and mechanism of action. Vitamin D must be converted to physiologically active compounds in the kidneys. Vitamin D helps to increase the calcium absorbed from the gastrointestinal tract and to regulate calcium deposited in the bones. This vitamin also stimulates some limited calcium absorption in the kidney. Because patients with CKD can't transform vitamin D to its active form, they may need a medication containing active vitamin D (calcitriol, also called

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