Effects of vitamin D supplements on bone metabolism in kidney transplant recipients: a systematic review and meta-analysis
Abstract
BACKGROUND: Vitamin D has been reported to decrease parathyroid hormone (PTH), reduce bone loss, and promote calcium absorption. However, its effects on bone metabolism in kidney transplant recipients (KTRs) remain controversial. This review aimed to analyze the effects of vitamin D supplements on bone metabolism in KTRs.
METHODS: We searched PubMed, EMBASE, Web of Science, and the Cochrane Library from inception through September 30, 2023, for randomized controlled trials (RCTs) on the effect of vitamin D on bone metabolism after kidney transplantation. We also searched the reference lists of systematic reviews and included studies. The outcomes were expressed using relative risk (RR) or standardized mean difference (SMD) with the corresponding 95% confidence interval (CI).
RESULTS: Fourteen studies involving a total of 985 KTRs were included in this analysis. The treatments consisted vitamin D supplementation at various doses and types. The duration of follow-up ranged from 3 to 12 months. More than half of the 14 studies (n = 8) had an overall high risk of bias, as they had at least one high-risk domain. Compared to placebo or no treatment, vitamin D supplementation significantly improved bone mineral density (BMD) at the femoral neck (SMD 0.54; 95% CI 0.10 to 0.98; P = 0.02), reduced serum PTH level (SMD -0.49; 95% CI -0.76 to -0.22; P = 0.0003), decreased bone alkaline phosphatase (BAP) level (SMD -0.31; 95% CI -0.52 to -0.09; P = 0.006), increased serum calcium level…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 8 participants or records.
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