Vitamin D and Chronic Kidney Disease

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  VITAMIN D AND CHRONIC KIDNEY DISEASE Presented by: Anna Paramitha Widjaja Kusuma (2012.061.122) Aurelianne (2012.061.126) Endy Suseno (2012.061.130) Supervisor: dr. Ruddy Alex Ticonuwu, Sp.PD  Introduction ã Vitamin D appears to play a role as  – a cell differentiating and anti-proliferative factor with actions in a variety of tissues,1,3,4 including the renal, cardiovascular, and immune systems ã In patients with CKD  – regulation of the reninangiotensin system (RAS)  – The nuclear factor (NF) kB pathway ã Two pathways involved in a broad range of pathological processes  ã It appears that adequate replacement of vitamin D in deficient populations could potentially reduce premature morbidity and mortality. ã Approach to vitamin D replacement in CKD patients into a new era where use of vitamin D is no longer solely for the treatment of secondary hyperparathyroidism.  VITAMIN D ã : prehormone obtained through the diet or via skin synthesis ã Activated in a sequential 2-step process  – 25-hydroxylation in the liver to produce 25-(OH)vitamin D  – 1-hydroxylation  – produce the active product 1,25 vitamin D or calcitriol
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