关键词: 肾功能不全, 慢性, 维生素D, 蛋白尿, 随机对照

Abstract:

Objective To investigate the renal protective effect of vitamin D and its analogs in non-dialysis patients with chronic kidney disease (CKD). Methods PubMed, Embase, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), etc. were searched according to the literature search strategy, and randomized controlled studies regarding the effects of vitamin D and its analogs on proteinuria and disease progression in CKD patients were included. Controlled studies were conducted, and the literature was screened according to the inclusion and exclusion criteria, the data of the included literature was meta-analyzed by Revman 5.4 software. Results A total of 7 articles with 616 patients were included.Compared with the control group, the vitamin D and its analogs reduced the ratio of urine protein/creatinine in CKD patients (SMD=-0.30, P=0.001; 95%CI:-0.48 to -0.12), decreased 24-hour urine protein (SMD=-0.67, P=0.01; 95%CI: -1.19 to -0.14), meantime, reduce serum parathyroid hormone (PTH) (SMD=-33.53, P=0.008; 95%CI: -58.48 to -8.58), increase serum calcium (SMD=0.11, P=0.04; 95%CI: 0.01 to 0.21), decreased blood phosphorus (SMD=-0.01, P=0.04; 95%CI: 0.01 to 0.21). However, the positive effect of vitamin D on serum creatinine (SMD=-9.41, P=0.38; 95%CI: -30.27 to 11.46) and estimated glomerular filtration rate ( eGFR ) (SMD=0.94, P=0.67; 95%CI: -3.35 to 5.22) was not observed. Conclusion Vitamin D and its analogs can reduce 24-hour proteinuria and urine protein/creatinine ratio in non-dialysis patients with CKD, also increase blood calcium level, reduce PTH, and inhibit the occurrence and development of secondary hyperparathyroidism. However, there is no evidence-based medical evidence to support the roles in reducing serum creatinine and improving renal function in CKD patients.

Key words: renal insufficiency, chronic, vitamin d, proteinuria, randomized control