Modulation of cardiometabolic risk and CardioRenal syndrome by oral vitamin D3 supplementation in Black and White Southern Sahara residents with chronic kidney disease Stage 3: focus on racial and ethnic disparities

Ren Fail. 2022 Dec;44(1):1243-1262. doi: 10.1080/0886022X.2022.2106244.

Abstract

Objectives: Several studies have shown that cholecalciferol supplementation (25OHD-S) in chronic kidney disease (CKD) improves kidney injury by reducing fibrosis-related vascular calcification and declining apoptosis-linked nephron damage.

Methods: The oral 25OHD-S was evaluated in 60,000 IU/month/36 weeks versus in 2000 IU/d/24 weeks in CKD Stage 3 with serum 25OHD level < 20 ng/mL. The study was undertaken on 156 black subjects and 150 white subjects Southern Sahara (SS). All biomarkers of cardiometabolic (CMet) and cardiorenal (CRenal) syndrome, Renin-angiotensin-aldosterone system (RAAS) profile, secondary hyperparathyroidism (SHPT), N-terminal pro B-type natriuretic peptide (NT-proBNP), Troponin T (cTnT) and atherogenicity risk were assessed by biochemical methods. Estimate glomerular filtration rate (eGFR) by chronic CKD-EPI equation formula. Total serum vitamin D by liquid chromatography-tandem mass spectrometry (MS).

Results: Vitamin D deficiency alters in the same manner CMet, CRenal, and others biomarkers in both groups SS; however, these disorders are more acute in blacks compared to whites SS. Oral 25OHD-S a highlighted improvement of eGFR drop, SHPT decrease, decline proteinuria, and cardiac failure risk (NT-proBNP and cTnT) attenuation. Concomitantly, 25OHD-S normalizes Renin, Aldosterone, and Angiotensin System (RAAS) activity. Nevertheless, homocysteine and Lp (a) do not modulate by 25OHD-S.

Conclusions: The oral vitamin D3 supplementation, according the dose, and the treatment duration does not like in black-skinned people versus to white-skinned inhabitants, while the 02 groups are native to the same Saharan environment. It emerge that a high intermittent dose through an extensive supplementation (60,000 IU/36 weeks) was more effective in black subjects. At opposite, a lower dose during a short period supplementation is sufficient (2000 IU/24 weeks) in white subjects.

Keywords: Chronic kidney disease; NT-proBNP; RAAS; SHPT; cardiometabolic; cardiorenal; racial and ethnicity; vitamin D.

MeSH terms

  • Biomarkers
  • Cardio-Renal Syndrome* / complications
  • Cardio-Renal Syndrome* / ethnology
  • Cardio-Renal Syndrome* / etiology
  • Cholecalciferol / administration & dosage
  • Cholecalciferol / therapeutic use
  • Dietary Supplements
  • Humans
  • Hyperparathyroidism, Secondary* / complications
  • Hyperparathyroidism, Secondary* / ethnology
  • Renal Insufficiency, Chronic*
  • Troponin T
  • Vitamin D Deficiency*

Substances

  • Biomarkers
  • Troponin T
  • Cholecalciferol

Grants and funding

This study was funded by the Algerian Agency for the Research and Development in Health (DGRSDT) and the Algerian Ministry of Higher Education Program.