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Vitamin D3 use has increased dramatically among chronic kidney disease patients

Posted on: April 10, 2014   by  Amber Tovey


New research published in the Journal of Renal Nutrition has found that use of vitamin D supplements in patients with chronic kidney disease has increased four-fold in recent years.

Twenty six million American adults have chronic kidney disease, while millions more are at risk for developing it. Chronic kidney disease (CKD) is loss of kidney function, and it progresses over time. As the disease progresses, waste can build to high levels in your blood to make you feel sick. The disease is associated with cardiovascular, metabolic, and infectious complications.

Some studies suggest vitamin D deficiency may contribute to these complications, making it an important modifiable risk factor. Despite this, researchers have yet to explore the use of vitamin D supplements in this group. If there’s okay to good evidence for the use of vitamin D supplements, are CKD patients using them?

Recently, researchers examined the trends in vitamin D supplement use in people with chronic kidney disease and the relationship of supplementation to vitamin D levels.

They examined rates of vitamin D supplementation among the participants from the Chronic Renal Insufficiency Cohort (CRIC). The CRIC is an ongoing observational study created in 2001 to continually examine risk factors for cardiovascular disease and CKD progression. All participants recruited for the cohort were diagnosed with mild to moderate chronic kidney disease.

The researchers in this study assessed the data on vitamin D supplement use from all 3,939 participants of the CRIC each year from 2003 to 2010.

The researchers were interested in whether vitamin D supplementation increased, decreased, or remained unchanged over the seven-year period.

They found the following:

  • Overall, use of vitamin D supplements increased from 10% to 44% over the 7 year study period. The increase in supplement use was mainly through patients using supplements containing only vitamin D3 or D2 more so than multivitamins containing vitamin D.
  • The predominant form of vitamin D supplement used switched from vitamin D2 (69.3% in 2003) to vitamin D3 (77.2% in 2010).

In a subgroup analysis, the researchers looked at 1,155 participants from the same cohort to compare the vitamin D levels of those using vitamin D supplements with those not using supplements. Here’s what the researchers found:

  • The vitamin D levels of those taking a supplement containing more than 400 IU/day was significantly higher with an average level of 42 ng/ml among non-Black participants and 40.5 ng/ml among Black participants.
  • Only 3.8% of non-Black and 16.5% of Black participants taking a supplement had levels lower than 20 ng/mL, compared to 22.7% of non-Black and 62.4% of Black participants not taking a supplement.

The researchers concluded,

“This study revealed an increasing use of cholecalciferol [vitamin D3] supplementation among participants in the CRIC study and that supplementation was associated with greater 25(OH)D levels.”

Although the results had significant findings, there were still some limitations. The biggest limitation of the study is the use of self-reporting, which may lead to inaccurate data on supplement use.

Furthermore, these findings suggest there will be limitations for future trials that are evaluating the effects of vitamin D supplementation on CKD. Since more and more CKD patients are supplementing with vitamin D, it will be more difficult to control patients’ use of supplements. However, these trials are needed in order to help determine how effective vitamin D supplementation is on the health of people with CKD.


Mariani et al. Increasing Use of Vitamin D Supplementation in the Chronic Renal Insufficiency Cohort Study. Journal of renal nutrition, 2014

7 Responses to Vitamin D3 use has increased dramatically among chronic kidney disease patients

  1. Rita and Misty

    Welcome, Amber. Thank you for an excellent article.

    By the way: shouldn’t everyone have an optimal 25(OH)D level?

    To me, an optimal vitamin D level should be the starting point from which all other studies move forward.

    For those VDC members wondering where I am on Facebook these days, the answer is simple: I have moved. Please if you would kindly follow me on Linkedin, I would be grateful to you. I would love to get a Linkedin dialogue started on vitamin D…

    So many folks still don’t know what they don’t know….

    Be well,

  2. [email protected]

    Yes, increasing vitamin D is great for everyone, but people with Kidney problems would do better if they supplemented with the form of vitamin D which does not require kidney processing before use.
    Note: there was a 60% increase in active vitamin D in people with poorly functioning kidneys when they increased the Omega-3 in their diets. http://vitamindwiki.com/tiki-index.php?page_id=3171
    Apparently the non-kidney portions of the body which can activate vitamin D need Omega-3.
    By the way, I take Omega-3 even though I do not have kidney problems – it appears to increase my response to vitamin D by about 20%.

  3. Rita and Misty

    I do think vitamin D works best with cofactors and Omega-3.


    The reason why I speak so much on vitamin D is that for years (my entire life really) I supplemented with Omega-3, boron, magnesium, zinc, and selenium. ( K and iodine are relatively new supplements for me)

    By the way, for years (and years) I also supplemented with vitamin D3 at 6,000 iu daily.

    But yet with this amount of D and with all these great cofactors, I was still deficient when tested. My level was only 32 ng/ml.

    Though I certainly like to think I am “special” I know in reality that I am not that unique. There must be other folks out there like me.

    Please remember to follow me on Linkedin, as I chat up vitamin D, and these great nonprofits like Vitamin D Council, Grassroots Health, Sunarc and VitaminDWiki 😉

    (where do you dance?)

  4. [email protected]

    Rita –
    1) How do we find you in Linked In?
    2) By extensive reading of the literature I have found MANY reasons for low response to Vitamin D
    27 reasons are currently listed in VitaminDWiki – most of which can be overcome
    email me if you have questions: [email protected]

  5. Rita and Misty


    Here I am 😉


    And everyone here is welcome to call me. My mobile is listed on my LInkedin account….
    Always leave a message, just in case for some reason life is in the way at any particular moment in time…I will call you back…scout’s honor.

    By the way, Henry, I have an absorption issue. And I am very foolish not to use a sun lamp. I know this. And I know that I cannot much longer put off doing so… To sun appropriately is very healthy…and I do need to do this… I know.

  6. msdestyni57564300

    I have just now been diagnosed with renal insufficiency. I also have extremely low levels of Vit D. What can I do to help with this issue? Do you recommend Vit D3 supplementation? If so, how much per day? And since you also suggest Omega3, how much of that per day? Right now my head is swimming bc I’m trying to take an active part in this and keep my kidneys from progressing further into the disease. Anyone who has any advice — I would greatly appreciate hearing it and suggestions! Thank you!

    • IAW

      To: msdestyni
      For the future there is a place at the top of the page that you can “click” on for Q and A to also ask questions.
      Keep checking back for other’s answers but the minimum recommendation for Vitamin D from the VDC is 5000iu per day of Vitamin D with it’s co-factors that are listed in the “About Vitamin D” also listed at the top of the page. Our recommendation is 5000iu but the safe upper limit is 10,000iu per day. We recommend a minimum blood level of 50ng/ml, the top of the range is 100ng/ml but 150ng/ml is safe. If you take 5000iu and do not reach a level of at least 50ng/ml, then you will have to take a higher amount.
      Hopefully Rita and Henry will tell you how much Omega’s they take.

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