Abstract
Background: Chronic kidney disease (CKD) patients on dialysis are prone to vitamin D insufficiency despite oral vitamin D supplementation. Here, we studied whether narrow-band ultraviolet B (NB-UVB) exposures improve vitamin D balance.
Methods: 14 haemodialysis patients and 15 healthy subjects receiving oral cholecalciferol 20 µg daily got nine NB-UVB exposures on the entire body. Serum 25-hydroxyvitamin D (25(OH)D) was measured by radioimmunoassay. Cutaneous mRNA expression levels of CYP27A1 and CYP27B1, two enzymes required for hydroxylation of vitamin D into its active metabolite, were also measured.
Results: The baseline serum 25(OH)D concentration was 57.6 ± 18.2 nmol/l in the CKD patients and 74.3 ± 14.8 nmol/l in the healthy subjects. The NB-UVB course increased serum 25(OH)D by 14.0 nmol/l (95% CI 8.7-19.5) and 17.0 nmol/l (CI 13.7-20.2), respectively. At baseline the CKD patients showed significantly increased CYP27B1 levels compared to the healthy subjects.
Conclusions: A short NB-UVB course is an efficient way to improve vitamin D balance in CKD patients on dialysis who are receiving oral vitamin D supplementation. The increased cutaneous CYP27B1 levels in the CKD patients suggest that the loss of renal activity of this enzyme is at least partially compensated for by the skin.
Methods: 14 haemodialysis patients and 15 healthy subjects receiving oral cholecalciferol 20 µg daily got nine NB-UVB exposures on the entire body. Serum 25-hydroxyvitamin D (25(OH)D) was measured by radioimmunoassay. Cutaneous mRNA expression levels of CYP27A1 and CYP27B1, two enzymes required for hydroxylation of vitamin D into its active metabolite, were also measured.
Results: The baseline serum 25(OH)D concentration was 57.6 ± 18.2 nmol/l in the CKD patients and 74.3 ± 14.8 nmol/l in the healthy subjects. The NB-UVB course increased serum 25(OH)D by 14.0 nmol/l (95% CI 8.7-19.5) and 17.0 nmol/l (CI 13.7-20.2), respectively. At baseline the CKD patients showed significantly increased CYP27B1 levels compared to the healthy subjects.
Conclusions: A short NB-UVB course is an efficient way to improve vitamin D balance in CKD patients on dialysis who are receiving oral vitamin D supplementation. The increased cutaneous CYP27B1 levels in the CKD patients suggest that the loss of renal activity of this enzyme is at least partially compensated for by the skin.
| Original language | English |
|---|---|
| Pages (from-to) | 17-22 |
| Number of pages | 6 |
| Journal | Nephron Clinical Practice |
| Volume | 124 |
| Issue number | 1-2 |
| DOIs | |
| Publication status | Published - Dec 2013 |
Bibliographical note
Copyright © 2013 S. Karger AG, Basel.Keywords
- 25-Hydroxyvitamin D3 1-alpha-Hydroxylase
- Administration, Oral
- Adolescent
- Aged
- Cholestanetriol 26-Monooxygenase
- Combined Modality Therapy
- Dietary Supplements
- Female
- Humans
- Male
- RNA, Messenger
- Renal Dialysis
- Renal Insufficiency, Chronic
- Skin
- Steroid Hydroxylases
- Treatment Outcome
- Ultraviolet Therapy
- Vitamin D
- Vitamin D Deficiency
- Young Adult
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Ala-Houhala, M. J., Vähävihu, K., Snellman, E., Hasan, T., Kautiainen, H., Karisola, P., Dombrowski, Y., Schauber, J., Saha, H., & Reunala, T. (2013). A narrow-band ultraviolet B course improves vitamin D balance and alters cutaneous CYP27A1 and CYP27B1 mRNA expression levels in haemodialysis patients supplemented with oral vitamin D. Nephron Clinical Practice, 124(1-2), 17-22. https://doi.org/10.1159/000355010