Nutritional vitamin D reduces CRP and improves albumin in maintenance hemodialysis patientsVitamin D May Lower Inflammation in Dialysis Patients

Frontiers in Medicine Published May 29, 2026 DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Consider nutritional vitamin D to reduce CRP and improve albumin in maintenance hemodialysis patients, noting similar safety versus placebo.

This is a meta-analysis of eight randomized controlled trials including 617 maintenance hemodialysis patients. The authors synthesized evidence on nutritional vitamin D supplementation versus placebo for inflammatory and nutritional markers. The pooled analysis found a significant mean decrease in C-reactive protein with nutritional vitamin D (MD −3.15, 95% CI −4.46 to −1.84; P < 0.05). This effect was observed in patients with baseline vitamin D deficiency (MD −2.64, 95% CI −4.47 to −0.81; P < 0.05) and those with normal baseline levels (MD −3.97, 95% CI −5.78 to −2.17; P < 0.05). Serum albumin also increased significantly (MD 0.55, 95% CI 0.10 to 1.01; P < 0.05), and immunoreactive parathyroid hormone decreased (SMD −0.56, 95% CI −1.07 to −−0.05; P < 0.05). The overall incidence of adverse reactions was similar between groups (P = 0.09), with no significant differences in hypercalcemia (P = 0.15) or hyperphosphatemia (P = 0.32). The authors acknowledge limitations such as not reported follow-up duration and funding or conflicts. Practice relevance is restrained, noting potential benefits for microinflammation and nutritional status without increased hypercalcemia or hyperphosphatemia risk.

This meta-analysis combined data from eight randomized controlled trials involving 617 patients on maintenance hemodialysis. The researchers looked at whether taking nutritional vitamin D helped compared to a placebo. They measured markers of inflammation, blood protein levels, and bone health hormones.

The study found that patients taking vitamin D had a significant decrease in C-reactive protein, a common marker of inflammation. This reduction was seen regardless of whether patients started with low vitamin D levels or normal levels. Additionally, vitamin D supplementation led to higher serum albumin levels and lower parathyroid hormone levels.

Safety was a key concern. The overall rate of adverse reactions was similar between the vitamin D group and the control group. There were no significant differences in the risk of high calcium or high phosphorus levels between the two groups. The authors suggest this treatment may improve microinflammation and nutritional status in hemodialysis patients.

What this means for you:

Vitamin D may lower inflammation and improve blood levels in dialysis patients without increasing safety risks.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

BackgroundMicroinflammation is widespread in Maintenance hemodialysis (MHD) patients. The continuous interaction of microinflammation and malnutrition is an independent risk factor for the clinical prognosis of MHD patients. Nutritional vitamin D deficiency is closely related to chronic kidney disease inflammation, but whether correcting this deficiency can improve microinflammation in the MHD population remains unclear.MethodsStudies published up to March 1, 2025 were included. Risk of bias was assessed using the Cochrane tool. RevMan 5.4 and Stata 17 were used for analyses, with heterogeneity assessed and random-effects models applied. Key outcomes included CRP, serum albumin, TNF-α, IL-1β, immunoreactive Parathyroid Hormone (iPTH), adverse events, hypercalcemia, and hyperphosphatemia.ResultsA total of 617 patients in eight randomized controlled trials were included. The experimental group interventions were nutritional vitamin D, while those of the control group were placebo. The meta-analysis showed that the decrease in CRP in the nutritional vitamin D intervention group was significantly higher than that in the control group [MD −3.15, 95% confidence interval (CI; −4.46, −1.84), P < 0.05]. Subgroup analysis demonstrated that nutritional vitamin D supplementation not only reduced CRP in MHD patients with baseline vitamin D deficiency, but also in those with normal vitamin D baseline levels [MD −2.64, 95% CI (−4.47, −0.81), P < 0.05; MD −3.97, 95% CI (−5.78, −2.17), P < 0.05]. The increase in serum albumin in the vitamin D group was more significant than in the control group [MD 0.55, 95% CI (0.10, 1.01), P < 0.05]. iPTH decreased more significantly in the vitamin D group than in the control group [SMD −0.56, 95% CI (−1.07, −0.05), P < 0.05]. In terms of safety, the overall incidence of adverse reactions in the nutritional vitamin D group was similar to that in the control group (P = 0.09). Moreover, no significant differences were found in the incidence of hypercalcemia and hyperphosphatemia between the two groups (P = 0.15, P = 0.32).ConclusionNutritional vitamin D supplementation may improve microinflammation and nutritional status in MHD patients, with potential benefits for bone metabolism and no apparent increase in the risk of hypercalcemia or hyperphosphatemia.

Nutritional vitamin D reduces CRP and improves albumin in maintenance hemodialysis patientsVitamin D May Lower Inflammation in Dialysis Patients

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Nutritional vitamin D reduces CRP and improves albumin in maintenance hemodialysis patientsVitamin D May Lower Inflammation in Dialysis Patients

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