The emerging role of nutritional vitamin D in secondary hyperparathyroidism in ckd

Chien Lin Lu, Dong Feng Yeih, Yi Chou Hou, Guey Mei Jow, Zong Yu Li, Wen Chih Liu, Cai Mei Zheng, Yuh Feng Lin, Jia Fwu Shyu, Remy Chen, Chung Yu Huang, Kuo Cheng Lu

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

In chronic kidney disease (CKD), hyperphosphatemia induces fibroblast growth factor-23 (FGF-23) expression that disturbs renal 1,25-dihydroxy vitamin D (1,25D) synthesis; thereby increasing parathyroid hormone (PTH) production. FGF-23 acts on the parathyroid gland (PTG) to increase 1α-hydroxylase activity and results in increase intra-gland 1,25D production that attenuates PTH secretion efficiently if sufficient 25D are available. Interesting, calcimimetics can further increase PTG 1α-hydroxylase activity that emphasizes the demand for nutritional vitamin D (NVD) under high PTH status. In addition, the changes in hydroxylase enzyme activity highlight the greater parathyroid 25-hydroxyvitmain D (25D) requirement in secondary hyperparathyroidism (SHPT); the higher proportion of oxyphil cells as hyperplastic parathyroid progression; lower cytosolic vitamin D binding protein (DBP) content in the oxyphil cell; and calcitriol promote vitamin D degradation are all possible reasons supports nutritional vitamin D (NVD; e.g., Cholecalciferol) supplement is crucial in SHPT. Clinically, NVD can effectively restore serum 25D concentration and prevent the further increase in PTH level. Therefore, NVD might have the benefit of alleviating the development of SHPT in early CKD and further lowering PTH in moderate to severe SHPT in dialysis patients.

Original languageEnglish
Article number1890
JournalNutrients
Volume10
Issue number12
DOIs
Publication statusPublished - Dec 1 2018

Fingerprint

hyperparathyroidism
Secondary Hyperparathyroidism
vitamin D
Vitamin D
parathyroid hormone
Parathyroid Hormone
Mixed Function Oxygenases
Oxyphil Cells
parathyroid glands
fibroblast growth factors
Parathyroid Glands
kidney diseases
Chronic Renal Insufficiency
vitamin D-binding protein
Vitamin D-Binding Protein
Hyperphosphatemia
calcitriol
Nutritional Support
cholecalciferol
Calcitriol

Keywords

  • Calcimimetics
  • Calcitriol
  • Nutritional vitamin D
  • Secondary hyperparathyroidism

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

Cite this

Lu, C. L., Yeih, D. F., Hou, Y. C., Jow, G. M., Li, Z. Y., Liu, W. C., ... Lu, K. C. (2018). The emerging role of nutritional vitamin D in secondary hyperparathyroidism in ckd. Nutrients, 10(12), [1890]. https://doi.org/10.3390/nu10121890

The emerging role of nutritional vitamin D in secondary hyperparathyroidism in ckd. / Lu, Chien Lin; Yeih, Dong Feng; Hou, Yi Chou; Jow, Guey Mei; Li, Zong Yu; Liu, Wen Chih; Zheng, Cai Mei; Lin, Yuh Feng; Shyu, Jia Fwu; Chen, Remy; Huang, Chung Yu; Lu, Kuo Cheng.

In: Nutrients, Vol. 10, No. 12, 1890, 01.12.2018.

Research output: Contribution to journalArticle

Lu, CL, Yeih, DF, Hou, YC, Jow, GM, Li, ZY, Liu, WC, Zheng, CM, Lin, YF, Shyu, JF, Chen, R, Huang, CY & Lu, KC 2018, 'The emerging role of nutritional vitamin D in secondary hyperparathyroidism in ckd', Nutrients, vol. 10, no. 12, 1890. https://doi.org/10.3390/nu10121890
Lu, Chien Lin ; Yeih, Dong Feng ; Hou, Yi Chou ; Jow, Guey Mei ; Li, Zong Yu ; Liu, Wen Chih ; Zheng, Cai Mei ; Lin, Yuh Feng ; Shyu, Jia Fwu ; Chen, Remy ; Huang, Chung Yu ; Lu, Kuo Cheng. / The emerging role of nutritional vitamin D in secondary hyperparathyroidism in ckd. In: Nutrients. 2018 ; Vol. 10, No. 12.
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