Vascular Access Dysfunction Significantly Reduced by Vitamin D

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Researchers reported that vitamin D supplementation lessened the risk of complications with vascular access among dialysis patients with type 2 diabetes. It was found that treatment with vitamin D2 was associated with a significantly reduced risk of vascular access dysfunction.

Vascular access for dialysis can be particularly problematic for patients with diabetes, who are already at risk for worse vascular outcomes. These complications are usually caused by venous neointimal hyperplasia near the graft or fistula. Most cells in the neointimal lesion are smooth muscle cells or precursors thereof, and they have an enzyme that converts vitamin D2 to vitamin D3. The researchers explained that this feature may enable vitamin D supplementation to suppress proliferation of vascular cell smooth muscle.

The study found that, contrary to prior findings, "having diabetes wasn't associated with an increased risk for venous-arterial dysfunction." But, they faulted the low number of diabetic patients populating those studies that caused those results. However, there were improvements in vascular access for patients with diabetes because taking vitamin D2 significantly reduced the risk of vascular access dysfunction.

Tamim Naber, MD, a nephrologist at MedAmerica Group in Ventnor, N.J., who was not involved in the study, said reducing vascular access is just one of the many advantages, including improvements in heart disease, offered by treating diabetic patients with vitamin D. He also cautioned that if patients are treated with more vitamin D, they need to be on the lookout "for changes in phosphorus and calcium, since treatment with vitamin D can increase phosphorus and calcium."

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