Document Type : Review articles

Authors

1 Department of Nephrology, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, P.R. China

2 Department of Nephrology, China-Japan Friendship Hospital, Beijing, P.R. China

Abstract

Context: Diabetic nephropathy is a common complication of diabetes mellitus with a higher incidence. Renin-angiotensin system blockers, as the main treatment for patients with diabetic kidney disease, can not only reduce albuminuria, but also lead to hyperkalaemia and creatinine. Therefore, additional protective therapeutic interventions are needed.
Evidence Acquisition: An electronic literature search was conducted in international and domestic databases including PubMed, Embase, CNKI, Scopus, Index Copernicus, DOAJ, and Wanfang database for trials up to January 2017. The search terms used were as follow: "Diabetic Nephropathies", "vitamin D3", "Cholecalciferol", "Calcitriol", "Alfacalcidol", "Paricalcitol", and "Randomized Controlled Trial". Quality assessments were evaluated with the Newcastle-Ottawa Quality Assessment Scale. Data were extracted by 2 independent reviewers (TJL and WGL). For all analysis, the standard mean difference (SMD) or odds ratio (OR) with 95% confidence intervals (CIs) were calculated, and heterogeneity of the studies was analyzed using I2 statistics.
Results: Twenty-four studies were (1,978 patients) identified in the literature retrieve process. The assessment scores indicated that all the admitted studies were reliable with scores ranging from 6 to 9. The pooled results indicated that vitamin D3 had a significant effect in reducing albuminuria (MD = -0.23, 95% CI: -0.30, -0.15) and that the vitamin D3 group had a low ratio of urinary microalbumin to creatinine than the control group (SMD = -0.49, 95% CI: -0.90, -0.08). The results also revealed that vitamin D3 group had a lower hs-CRP than the control group (MD = -0.80, 95% CI: -1.26, -0.34).
Conclusions: Based on the evidence of this study, vitamin D3 could be suggested as a recommended drug for patients with diabetic nephropathy in clinical practice.

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