THE PROTECTIVE ROLE OF VITAMIN D ON THE HEART AND THE KIDNEY

WALTER MANUCHA; LUIS JUNCOS

Therapeutic advances in cardiovascular disease.

SAGE PUBLICATIONS INC

Lugar: London; Año: 2017 vol. 11 p. 12 - 19

For long time, vitamin D was regarded as an essential compound for the maintenance of appropriate calcium metabolism. Indeed, this calcium-related function were broadly studied and validated in numerous clinical and epidemiologic studies. All these vitamin D effects are mediated by a specific receptor. Remarkably, recent investigations show that the vitamin D receptor also affects autoimmunity and by these means, the course of neoplasias and tissue inflammation. Moreover, the vitamin D receptor regulates genes that affect cellular activity including cell differentiation and apoptosis and by these means angiogenesis. Actually, vitamin D deficiency has been associated to structural and functional cardiovascular changes that can be reversed by receptor stimulation. Indeed, injurious effects of vitamin D deficiency such as myocardial hypertrophy and high blood pressure seem linked to increased renin-angiotensin activity. Interestingly, chronic renal disease, a condition often associated to greater cardiovascular risk, high blood pressure, myocardial hypertrophy and inappropriate stimulation of the renin angiotensin system, is also tied to inadequate vitamin D activity. In fact, studies in several animal models as the rat ureteral obstruction model, the 5/6 nephrectomy model and others, clearly show that vitamin D receptor stimulation prevents both structural and functional changes in the heart and the kidney. Clinical trials are needed to validate the vitamin D potential benefits in chronic kidney disease and its associated cardiovascular risk.