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Mohammed Abdel Gawad MD Neph, ESENeph
Lecturer of Nephrology, School of Medicine, NewGiza University
NephrologyConsultant,Alexandria
Founder of NephroTube.com
Chairof AFRAN Web/Media Committee
ISN Africa RegionalBoard
drgawad@gmail.com
Vitamin D in Chronic Kidney Disease
Which type, Which dose, Which patient?
To download the lecture
contact me
drgawad@gmail.com
For more Nephrology lectures visit
www.NephroTube.com
Visit
www.NephroTube.com
for more lectures
LectureOutline
• Vitamin D normal physiology and changes in CKD
• Which vitamin D to measure at laboratory? Vitamin D level?
• Vitamin D pleiotropic effect
• Vitamin D use in CKD-MBD and vit D different forms/dosage
• Hypomagnesemia and vitamin D deficiency in CKD
• Suggestions for future research
LectureOutline
• Vitamin D normal physiology and changes in CKD
• Which vitamin D to measure at laboratory? Vitamin D level?
• Vitamin D pleiotropic effect
• Vitamin D use in CKD-MBD and vit D different forms/dosage
• Hypomagnesemia and vitamin D deficiency in CKD
• Suggestions for future research
In CKD
In CKD
Nat Rev Nephrol. 2017 Jan;13(1):27-38
Semin Nephrol.2014 Nov;34(6):660-8
LectureOutline
• Vitamin D normal physiology and changes in CKD
• Which vitamin D to measure at laboratory? Vitamin D level?
• Vitamin D pleiotropic effect
• Vitamin D use in CKD-MBD and vit D different forms/dosage
• Hypomagnesemia and vitamin D deficiency in CKD
• Suggestions for future research
Whichvit D to measure at laboratory?
J Bone Miner Res. 2007 Nov;22(11):1668-71
Measuredat
laboratories
Phys Sportsmed. 2015 May;43(2):161-8
LectureOutline
• Vitamin D normal physiology and changes in CKD
• Which vitamin D to measure at laboratory? Vitamin D level?
• Vitamin D pleiotropic effect
• Vitamin D use in CKD-MBD and vit D different forms/dosage
• Hypomagnesemia and vitamin D deficiency in CKD
• Suggestions for future research
Int J Mol Sci. 2022 Aug 15;23(16):9135
Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
All-cause death in trials
comparing vitamin D with
placebo or no treatment
128 studies involving 11,270
adults with stage 3, 4, or 5
CKD, including kidney failure
treated with dialysis
Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
128 studies involving 11,270
adults with stage 3, 4, or 5
CKD, including kidney failure
treated with dialysis
Cardiovascular death in
trials comparing vitamin D
with placebo or no
treatment
Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
128 studies involving 11,270
adults with stage 3, 4, or 5
CKD, including kidney failure
treated with dialysis
Fracture outcomes in trials
comparing vitamin D with
placebo or no treatment
Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
Calcif Tissue Int. 2021 Aug;109(2):157-178
LectureOutline
• Vitamin D normal physiology and changes in CKD
• Which vitamin D to measure at laboratory? Vitamin D level?
• Vitamin D pleiotropic effect
• Vitamin D use in CKD-MBD and vit D different forms/dosage
• Hypomagnesemia and vitamin D deficiency in CKD
• Suggestions for future research
Int J Mol Sci. 2022 Aug 15;23(16):9135
Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
128 studies involving 11,270
adults with stage 3, 4, or 5
CKD, including kidney failure
treated with dialysis
Fracture outcomes in trials
comparing vitamin D with
placebo or no treatment
Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
In CKD
Calcidiolreplacement inCKD
(cholecalciferolD3, ergocalciferolD2)
The decision of whether to measure, when to
measure, how often, and to what target level needs to
be individualized.
Correction of vitamin D deficiency – Protocol 1
Calcif Tissue Int. 2021 Aug;109(2):157-178
Calcif Tissue Int. 2021 Aug;109(2):157-178
Correction of vitamin D deficiency – Protocol 2
Calcif Tissue Int. 2021 Aug;109(2):157-178
Stopvit D supplementation
if there is hypercalcemia
Calcif Tissue Int. 2021 Aug;109(2):157-178
Stopvit D supplementation
if there is lowPTH
In CKD
Calcidiolreplacement inCKD
(cholecalciferolD3, ergocalciferolD2)
Calcitriolor analogue
replacementin CKD
Calcitriolor analogue
replacementin CKD
Clin J Am Soc Nephrol.2010 Mar;5(3):512-8
Alfacalcidol and doxercalciferol
Clin J Am Soc Nephrol.2010 Mar;5(3):512-8
Clin J Am Soc Nephrol.2010 Mar;5(3):512-8
Clin J Am Soc Nephrol.2010 Mar;5(3):512-8
Archives of Osteoporosis(2020) 15: 182
LectureOutline
• Vitamin D normal physiology and changes in CKD
• Which vitamin D to measure at laboratory? Vitamin D level?
• Vitamin D pleiotropic effect
• Vitamin D use in CKD-MBD and vit D different forms/dosage
• Hypomagnesemia and vitamin D deficiency in CKD
• Suggestions for future research
Lecture Outline
• Vitamin D normal physiology and changes in CKD
• Which vitamin D to measure at laboratory? Vitamin D level?
• Vitamin D pleiotropic effect
• Vitamin D use in CKD-MBD and vit D different forms/dosage
• Hypomagnesemia and vitamin D deficiency in CKD
• Suggestions for future research
Am J Kidney Dis. 2023 Sep 16:S0272-6386(23)00740-0
Vitamin D in Chronic Kidney Disease Which type, Which dose, Which patient? - Dr. Gawad

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Vitamin D in Chronic Kidney Disease Which type, Which dose, Which patient? - Dr. Gawad

  • 1. Mohammed Abdel Gawad MD Neph, ESENeph Lecturer of Nephrology, School of Medicine, NewGiza University NephrologyConsultant,Alexandria Founder of NephroTube.com Chairof AFRAN Web/Media Committee ISN Africa RegionalBoard drgawad@gmail.com Vitamin D in Chronic Kidney Disease Which type, Which dose, Which patient?
  • 2. To download the lecture contact me drgawad@gmail.com For more Nephrology lectures visit www.NephroTube.com
  • 4.
  • 5. LectureOutline • Vitamin D normal physiology and changes in CKD • Which vitamin D to measure at laboratory? Vitamin D level? • Vitamin D pleiotropic effect • Vitamin D use in CKD-MBD and vit D different forms/dosage • Hypomagnesemia and vitamin D deficiency in CKD • Suggestions for future research
  • 6. LectureOutline • Vitamin D normal physiology and changes in CKD • Which vitamin D to measure at laboratory? Vitamin D level? • Vitamin D pleiotropic effect • Vitamin D use in CKD-MBD and vit D different forms/dosage • Hypomagnesemia and vitamin D deficiency in CKD • Suggestions for future research
  • 7.
  • 9. In CKD Nat Rev Nephrol. 2017 Jan;13(1):27-38
  • 11. LectureOutline • Vitamin D normal physiology and changes in CKD • Which vitamin D to measure at laboratory? Vitamin D level? • Vitamin D pleiotropic effect • Vitamin D use in CKD-MBD and vit D different forms/dosage • Hypomagnesemia and vitamin D deficiency in CKD • Suggestions for future research
  • 12. Whichvit D to measure at laboratory? J Bone Miner Res. 2007 Nov;22(11):1668-71 Measuredat laboratories
  • 13. Phys Sportsmed. 2015 May;43(2):161-8
  • 14. LectureOutline • Vitamin D normal physiology and changes in CKD • Which vitamin D to measure at laboratory? Vitamin D level? • Vitamin D pleiotropic effect • Vitamin D use in CKD-MBD and vit D different forms/dosage • Hypomagnesemia and vitamin D deficiency in CKD • Suggestions for future research
  • 15. Int J Mol Sci. 2022 Aug 15;23(16):9135
  • 16. Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5 All-cause death in trials comparing vitamin D with placebo or no treatment 128 studies involving 11,270 adults with stage 3, 4, or 5 CKD, including kidney failure treated with dialysis
  • 17. Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5 128 studies involving 11,270 adults with stage 3, 4, or 5 CKD, including kidney failure treated with dialysis Cardiovascular death in trials comparing vitamin D with placebo or no treatment
  • 18. Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5 128 studies involving 11,270 adults with stage 3, 4, or 5 CKD, including kidney failure treated with dialysis Fracture outcomes in trials comparing vitamin D with placebo or no treatment
  • 19. Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
  • 20. Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
  • 21. Calcif Tissue Int. 2021 Aug;109(2):157-178
  • 22. LectureOutline • Vitamin D normal physiology and changes in CKD • Which vitamin D to measure at laboratory? Vitamin D level? • Vitamin D pleiotropic effect • Vitamin D use in CKD-MBD and vit D different forms/dosage • Hypomagnesemia and vitamin D deficiency in CKD • Suggestions for future research
  • 23. Int J Mol Sci. 2022 Aug 15;23(16):9135
  • 24. Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5 128 studies involving 11,270 adults with stage 3, 4, or 5 CKD, including kidney failure treated with dialysis Fracture outcomes in trials comparing vitamin D with placebo or no treatment
  • 25. Am J Kidney Dis. 2023 Jun 24:S0272-6386(23)00693-5
  • 27.
  • 28. The decision of whether to measure, when to measure, how often, and to what target level needs to be individualized.
  • 29.
  • 30. Correction of vitamin D deficiency – Protocol 1 Calcif Tissue Int. 2021 Aug;109(2):157-178
  • 31. Calcif Tissue Int. 2021 Aug;109(2):157-178 Correction of vitamin D deficiency – Protocol 2
  • 32. Calcif Tissue Int. 2021 Aug;109(2):157-178 Stopvit D supplementation if there is hypercalcemia
  • 33. Calcif Tissue Int. 2021 Aug;109(2):157-178 Stopvit D supplementation if there is lowPTH
  • 34. In CKD Calcidiolreplacement inCKD (cholecalciferolD3, ergocalciferolD2) Calcitriolor analogue replacementin CKD
  • 35. Calcitriolor analogue replacementin CKD Clin J Am Soc Nephrol.2010 Mar;5(3):512-8 Alfacalcidol and doxercalciferol
  • 36. Clin J Am Soc Nephrol.2010 Mar;5(3):512-8
  • 37. Clin J Am Soc Nephrol.2010 Mar;5(3):512-8
  • 38. Clin J Am Soc Nephrol.2010 Mar;5(3):512-8
  • 40.
  • 41. LectureOutline • Vitamin D normal physiology and changes in CKD • Which vitamin D to measure at laboratory? Vitamin D level? • Vitamin D pleiotropic effect • Vitamin D use in CKD-MBD and vit D different forms/dosage • Hypomagnesemia and vitamin D deficiency in CKD • Suggestions for future research
  • 42.
  • 43. Lecture Outline • Vitamin D normal physiology and changes in CKD • Which vitamin D to measure at laboratory? Vitamin D level? • Vitamin D pleiotropic effect • Vitamin D use in CKD-MBD and vit D different forms/dosage • Hypomagnesemia and vitamin D deficiency in CKD • Suggestions for future research
  • 44. Am J Kidney Dis. 2023 Sep 16:S0272-6386(23)00740-0