Vitamin D Status and Potential Therapeutic Options in Critically Ill Patients: A Narrative Review of the Clinical Evidence

Vitamin D covers roles of paramount importance in the regulation of multiple physiological pathways of the organism. The metabolism of vitamin D involves kidney–liver crosstalk and requires an adequate function of these organs, where vitamin D is progressively turned into active forms. Vitamin D def...

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Bibliographic Details
Published in:Diagnostics (Basel) 2022-11, Vol.12 (11), p.2719
Main Authors: Cutuli, Salvatore L, Cascarano, Laura, Tanzarella, Eloisa S, Lombardi, Gianmarco, Carelli, Simone, Pintaudi, Gabriele, Grieco, Domenico L, De Pascale, Gennaro, Antonelli, Massimo
Format: Article
Language:English
Subjects:
acute kidney injury
acute liver dysfunction
acute respiratory failure
Alfacalcidol
Calcifediol
Care and treatment
Clinical trials
critical care
Critically ill
Cytochrome
Epidemiology
Health aspects
Hormones
Metabolism
Metabolites
Osteoporosis
Pathophysiology
Physiology
Review
sepsis
Vitamin D
Vitamin deficiency
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Summary:Vitamin D covers roles of paramount importance in the regulation of multiple physiological pathways of the organism. The metabolism of vitamin D involves kidney–liver crosstalk and requires an adequate function of these organs, where vitamin D is progressively turned into active forms. Vitamin D deficiency has been widely reported in patients living in the community, being prevalent among the most vulnerable subjects. It has been also documented in many critically ill patients upon admission to the intensive care unit. In this context, vitamin D deficiency may represent a risk factor for the development of life-threatening clinical conditions (e.g., infection and sepsis) and worse clinical outcomes. Several researchers have investigated the impact of vitamin D supplementation showing its feasibility, safety, and effectiveness, although conflicting results have put into question its real benefit in critically ill patients. The existing studies included heterogeneous critically ill populations and used slightly different protocols of vitamin D supplementation. For these reasons, pooling up the results is difficult and not conclusive. In this narrative review, we described vitamin D physiology and the pathophysiology of vitamin D depletion with a specific focus on critically ill patients with liver dysfunction, acute kidney injury, acute respiratory failure, and sepsis.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics12112719