Vitamin D Supplementation and Cardiovascular Outcomes in CKD

ANNA 2021 National Symposium The prevalence of cardiovascular disease is higher among patients with chronic kidney disease (CKD) than in the general population. Patients with CKD commonly have vitamin D deficiency, an imbalance that has recently been linked to cardiovascular disease, due to an increased risk of inflammation and dysfunction of the vascular endothelium. Awareness among primary care providers of the association between vitamin D deficiency and cardiovascular disease in patients with CKD can help prevent adverse cardiovascular outcomes. Alix M, Duarte Gomez, MSN, RN, and Fay Callejo Gbolo, MPH, MSN, RN, of Columbia University School of Nursing, New York, New York, conducted a review of the current evidence on the impact of vitamin D supplementation in adults with non-dialysis dependent CHD. Results of the review were reported during a virtual poster session at the ANNA 2021 National Symposium in a poster titled Evaluating the Impact of Vitamin D Supplementation in Cardiovascular Outcomes in Patients with Chronic Kidney Disease Not Requiring Dialysis. The researchers searched PubMed, CINAHL, and EMBASE using the search terms “chronic kidney disease AND vitamin D AND cardiovascular disease.” Population-based studies published between 2015 and 2020 that used flow mediated dilation (FMD) and/or pulse wave velocity (PWV) as proxies for cardiovascular function in non-dialysis dependent adults with CKD were eligible for review, as were eligible studies from the reference lists of those articles. Non-human and pediatric studies were excluded, as were studies that included patients on dialysis. A total of nine articles met inclusion criteria. The review revealed conflicting evidence regarding the impact of vitamin D supplementation on adults with non-dialysis dependent CKD. Most of the studies found an association between vitamin D supplementation and improved FMD/PWV measurements, demonstrating improved vascular elasticity and cardiovascular health. However, those results may have been due partially to some studies including patients diagnosed with cardiovascular disease taking medications such as antihypertensives. “Therefore, more well-designed studies, with longer follow-ups, are required to better determine the effects of vitamin D supplementation on cardiovascular health in non-dialysis CKD patients to best determine the true added benefit with vitamin D supplementation, as well as its cost-effectiveness,” the authors said. Source: Duarte Gomez AM, Gbolo FC. Evaluating the impact of vitamin D supplementation in cardiovascular outcomes in patients with chronic kidney disease not requiring dialysis. Abstract of a poster presented at the virtual 2021 American Nephrology Nurses Association National Symposium, May 2-5, 2021.