Effects of vitamin D deficiency on progression of chronic kidney disease: A systematic review and meta-analysis

Sayed Yousef Mojtahedi Paniz Pourpashang ^*

• Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran

Chronic kidney disease (CKD) is a major global health issue with increasing prevalence, progressing to end-stage renal disease (ESRD) and posing significant clinical challenges.Emerging evidence suggests vitamin D deficiency may contribute to CKD progression, but the relationship remains inconclusive. This systematic review and meta-analysis evaluated the association between vitamin D deficiency and CKD progression, focusing on changes in estimated glomerular filtration rate (eGFR), ESRD progression, and dialysis need. A systematic search of PubMed, Scopus, Web of Science, and Embase identified relevant observational and cohort studies from 1990 to 2024. Eligible studies reported baseline vitamin D levels and CKD progression outcomes. A random-effects meta-analysis calculated the pooled odds ratio (OR) for CKD progression. Subgroup analyses examined follow-up duration, study quality, and comorbid conditions. Twelve studies (n=182-36,523 participants) met the inclusion criteria. Patients with vitamin D deficiency had a 43% increased odds of CKD progression (OR=1.43, 95% CI: 1.05-1.96, P=0.023). Subgroup analysis showed a stronger association in long-term follow-up studies (≥5 years) (OR=2.04, 95% CI: 1.34-3.11, P=0.001), cohort studies (OR=1.95, 95% CI: 1.22-3.20, P=0.005), and high-quality studies (OR=1.38, 95% CI: 1.10-1.72, P=0.005). No significant publication bias was detected. Findings suggest vitamin D deficiency is associated with an increased risk of CKD progression, supporting the importance of routine vitamin D screening and supplementation in CKD management. Further randomized controlled trials are needed to determine the therapeutic role of vitamin D in slowing CKD progression.