Abstract: FR-PO974
Effect of Cholecalciferol Supplementation on Immune Modulation, Inflammation, and Vascular Function in CKD
Session Information
- CKD Interventions: Trials and Quality Improvement
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Kamboj, Kajal, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Naik, Sachin Motiram, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Chaudhary, Ankur, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Singhal, Manphool, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Kumar, Vivek, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Yadav, Ashok Kumar, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
- Jha, Vivekanand, The George Institute for Global Health India, New Delhi, Delhi, India
Background
Vitamin D deficiency is common in chronic kidney disease (CKD) and short term studies have shown beneficial effect of vitamin D supplementation on vascular function in CKD. In this study we investigated the effect of cholecalciferol supplementation on vascular and immune functions in non-diabetic patients with early stage CKD.
Methods
In this pre-post study, non-diabetic CKD with eGFR 15-60 ml/min/1.73m2 and 25(OH)D levels <20 ng/ml were enrolled. Participants receive 300000 IU of cholecalciferol at enrolment and 8 weeks. Change in circulating T cell subsets, flow mediated dilatation (FMD), serum levels of pro and anti-inflammatory cytokines and mRNA expression of Cathelicidin, VDR, Cyp27b1, IL-10 were analysed at 16 weeks.
Results
Out of these 69 participants enrolled, 62 participants completed follow up. 25(OH)D levels increased at 16 weeks (14.4 ± 8.6 ng/ml vs 39.8 ± 19.1 ng/ml, P<0.001). A significant increase in Th2 cell and Th17 population was noted whereas no change was observed in Th1 and Treg cell populations (Table 1). FMD showed a significant increase at 16 weeks (10.54± 6.30 % vs 13.82±8.62 %, P=0.02). Increased mRNA expression of Cathelicidin, IL-10, VDR and Cyp27b1 by 2 to12 fold (Fig.1A) and significant changes in levels of various pro-inflammatory and anti-inflammatory cytokines (Fig.1B) were observed at follow-up.
Conclusion
Cholecalciferol supplementation in vitamin D deficient patients with non-diabetic CKD significantly improved the immune and vascular function, inflammatory responses and enhanced the expression of vitamin D responsive.
Table 1: Levels of various T cell subpopulation
| T cell subpopulation | T cell marker | Baseline (%cells) | Follow up (%cells) | P value |
| TH1 cells | CD3+CD4+CXCR3+ CD3+CD4+Tbet+ CD3+CD4+IFNg+ | 40 ± 19.27 13.63 ± 13.75 19.32 ± 14.29 | 30.08 ± 15.37 15.41 ± 13.34 23.20 ± 16.75 | 0.736 0.183 0.229 |
| TH2 cells | CD3+CD4+IL4+ CD3+CD4+STAT6+ CD3+CD4+GATA3+ | 11.33 ± 9.51 13.63 ± 14.16 22.09 ± 13.93 | 19.72 ± 17.45 13.58 ± 10 21.17 ± 12.26 | 0.006 0.503 0.828 |
| TH17 cells | CD3+CD4+IL17+ CD3+CD4+RORgt+ | 6.33 ± 6.20 14.19 ± 11.14 | 13.22 ± 16.54 15.48 ± 16.20 | 0.004 0.909 |
| Treg cells | CD3+CD4+CD25+ CD3+CD4+CD25+CD127-FOXP3+ | 16.42 ± 10.01 3.67 ± 3.55 | 17.09 ± 14.34 3.79 ± 2.34 | 0.981 0.270 |
Funding
- Government Support – Non-U.S.