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BioMed Research International - Volume 2015 2015, Article ID 145828, 11 pages -

Review Article

Department of Clinical and Experimental Medicine, University of Messina, Via Faranda, 2-98123 Messina, Italy

Department ofBiomedical Sciences and Morphological and Functional Imaging, University of Messina, Italy

Comenius University, Bratislava, Slovakia

University Hospital CHUV, Lausanne, Switzerland

Second University of Naples, Naples, Italy

Received 28 November 2014; Revised 30 January 2015; Accepted 4 February 2015

Academic Editor: Ronald L. Klein

Copyright © 2015 Domenico Santoro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


For many years deficiency of vitamin D was merely identified and assimilated to the presence of bone rickets. It is now clear that suboptimal vitamin D status may be correlated with several disorders and that the expression of 1-α-hydroxylase in tissues other than the kidney is widespread and of clinical relevance. Recently, evidence has been collected to suggest that, beyond the traditional involvement in mineral metabolism, vitamin D may interact with other kidney hormones such as renin and erythropoietin. This interaction would be responsible for some of the systemic and renal effects evoked for the therapy with vitamin D. The administration of analogues of vitamin D has been associated with an improvement of anaemia and reduction in ESA requirements. Moreover, vitamin D deficiency could contribute to an inappropriately activated or unsuppressed RAS, as a mechanism for progression of CKD and-or cardiovascular disease. Experimental data on the anti-RAS and anti-inflammatory effects treatment with active vitamin D analogues suggest a therapeutic option particularly in proteinuric CKD patients. This option should be considered for those subjects that are intolerant to anti-RAS agents or, as add-on therapy, in those already treated with anti-RAS but not reaching the safe threshold level of proteinuria.

Autor: Domenico Santoro, Daniela Caccamo, Silvia Lucisano, Michele Buemi, Katerina Sebekova, Daniel Teta, and Luca De Nicola



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