Vitamin D and Acute Kidney Injury: A Two-Way Causality Relation and a Predictive, Prognostic, and Therapeutic Role of Vitamin D.

Spyridon Graidis,Maria Papaioannou,Theodosios S Papavramidis

doi:10.3389/fnut.2020.630951

Spyridon Graidis, Maria Papaioannou + Show 1 more

Open Access

https://doi.org/10.3389/fnut.2020.630951

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Abstract

Background: Acute kidney injury (AKI) constitutes a multi-factorially caused condition, which significantly affects kidney function and can lead to elevated risk of morbidity and mortality. Given the rising scientific evidence regarding vitamin D's (VitD's) multisystemic role, the connection between AKI and VitD is currently being studied, and the complex relation between them has started to be unraveled.Methods: A systematic review had been conducted to identify the pathogenetic relation of VitD and AKI and the potential role of VitD as a biomarker and therapeutic–renoprotective factor.Results: From 792 articles, 74 articles were identified that fulfilled the inclusion criteria. Based on these articles, it has been found that not only can VitD disorders (VitD deficiency or toxicity) cause AKI but, also, AKI can lead to great disruption in the metabolism of VitD. Moreover, it has been found that VitD serves as a novel biomarker for prediction of the risk of developing AKI and for the prognosis of AKI's severity. Finally, animal models showed that VitD can both ameliorate AKI and prevent its onset, suggesting its renoprotective effect.Conclusion: There is a complex two-way pathogenetic relation between VitD disorders and AKI, while, concomitantly, VitD serves as a potential novel predictive–prognostic biomarker and a treatment agent in AKI therapy.

Highlights

Acute kidney injury (AKI), acute kidney failure (AKF), or acute renal failure (ARF) is a multi-factorially caused condition, characterized by sudden and rapid loss of kidney function
During the diuretic phase, an elevation of 25(OH)D and 1,25(OH)2D was observed, which was greater in patients who developed hypercalcemia [16]. These results suggest that the elevation of serum 1,25(OH)2D plays an important role in the development of hypercalcemia and that this increase may be due to extrarenal production or/and dysregulated renal production
The combined administration of both drugs led to an enhanced therapeutic effect. These results propose a merger of vitamin D (VitD) and endothelin-1 signaling pathways, which is promising as a therapeutic option for cisplatin-induced AKI [44]

Summary

Introduction

Acute kidney injury (AKI), acute kidney failure (AKF), or acute renal failure (ARF) is a multi-factorially caused condition, characterized by sudden and rapid loss of kidney function. Acute kidney injury results in further systemic disorders and is related to elevated morbidity and mortality [1]. There are many different definitions for AKI, characterized by different biochemical, physiological, and clinical cutoff points. Crosstalk Between Vitamin D and the Acute Kidney Injury. Improving Global Guidelines (KDIGO) Clinical Practice Guidelines for Acute Kidney Injury definition, there are three stages of AKI. Acute kidney injury (AKI) constitutes a multi-factorially caused condition, which significantly affects kidney function and can lead to elevated risk of morbidity and mortality. Given the rising scientific evidence regarding vitamin D’s (VitD’s) multisystemic role, the connection between AKI and VitD is currently being studied, and the complex relation between them has started to be unraveled

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