Effects of cholecalciferol supplementation in Autosomal Dominant Polycystic Kidney Disease (ADPKD) patients

Abstract

Hypertension and inflammation have been associated with Autosomal Dominant Polycystic Kidney Disease (ADPKD) progression. We have previously observed an inverse correlation between serum levels of 25-hydroxyvitamin D [25(OH)D] and vitamin D receptor (VDR) expression with total kidney volume, a surrogate marker of disease progression. The present study aimed to determine the effects of a short-term cholecalciferol supplementation upon arterial pressure, hormonal, biochemical parameters and inflammatory markers in ADPKD patients with hypovitaminosis D. Vitamin D-insufficient ADPKD patients (15 M/27F, 41.5 ± 11.8 years) with an estimated Glomerular Filtration Rate (eGFR) of 75.4 ± 34.6 mL/min/1.73 m 2 were randomly assigned to receive a single monthly dose of vitamin D 3 or placebo for 3 months. Blood pressure (BP) was measured through 24-h ambulatory BP monitoring (ABPM), serum 25(OH)D levels, monocyte expression of its regulatory enzymes (CYP24A1 and CYP27B1) and VDR, as well as inflammatory markers (IL-6, IL-10, CRP and NFkB serum levels) were determined at baseline and at the end of the study. At the end of the study, [25(OH)D] levels have been restored in cholecalciferol group (37 ± 10 versus 19 ± 4 ng/mL, p < 0.001) but not in placebo (22 ± 5 versus 22 ± 6 ng/mL, p = 0.83). However, VDR, CYP24A1/CYP27B1 monocyte expression, inflammatory markers and ABPM parameters were not statistically different from baseline. Present findings suggested that a short-term cholecalciferol supplementation in the current doses was not able to modify inflammatory nor blood pressure parameters in ADPKD patients with 25(OH)D insufficiency. • Hypertension and inflammation have been associated ADPKD progression. We have previously observed an inverse correlation between serum levels of 25(OH)D and vitamin D receptor (VDR) expression with total kidney volume, a surrogate marker of disease progression. • We currently evaluated the effects of a controlled short-term cholecalciferol supplementation upon arterial pressure, hormonal, biochemical parameters and inflammatory markers in ADPKD patients with hypovitaminosis D. • Serum levels of 25(OH)D have been restored in vitamin D-insufficient ADKPD patients after 3 months of cholecalciferol but not placebo supplementation. However, inflammatory nor blood pressure parameters have been modified by supplementation. • Further studies employing higher doses or for longer periods are still warranted to determine if such intervention could change clinical outcomes or predictors of progression in ADPKD.