2025-03-122025-03-122024-11-13COSTA, Danilo Evangelista; CHAGAS, Fernando Moraes da Costa. Influência da vitamina D sobre os estágios iniciais da doença renal do diabetes em pessoas com diabetes mellitus tipo 1. Orientadora: Ana Carolina Contente Braga de Souza. 2024. 104 f. Trabalho de Curso (Bacharelado em Medicina) - Faculdade de Medicina, Instituto de Ciências Médicas, Universidade Federal do Pará, Belém, 2024. Disponível em: https://bdm.ufpa.br/jspui/handle/prefix/7824. Acesso em:.https://bdm.ufpa.br/jspui/handle/prefix/7824Diabetic Kidney Disease (DKD) is the leading cause of chronic kidney disease. The initial clinical sign is microalbuminuria, also referred to as elevated Urinary Albumin Excretion (UAE). Experimental, observational studies, and clinical trials suggest that Vitamin D (VD) can slow the progression of DKD, through isolated or synergistic action with inhibitors of the renin-angiotensin-aldosterone system. This study aimed to evaluate the effects of high doses of cholecalciferol on elevated UAE and the Glomerular Filtration Rate (GFR) in patients with Type 1 Diabetes Mellitus (T1DM). A non-randomized clinical trial was conducted, recruiting T1DM patients from the Endocrinology outpatient clinic of the João de Barros Barreto University Hospital. Participants were selected with a GFR > 30 ml/min/1.73 m2 and microalbuminuria (> 30 mg/g or 30 mg/24h and < 300 mg/g or 300 mg/24h). Patients were divided into two groups based on baseline levels of 25-hydroxy-vitamin D – 25(OH)D, receiving 10,000 IU/day of cholecalciferol if 25(OH)D < 30 ng/ml, and 4000 IU/day if 25(OH)D > 30 ng/ml, over 12 weeks. Data collected before and after the intervention included 24-hour microalbuminuria, isolated microalbuminuria, and creatinine. Seventeen individuals participated in this study, with an average age of 27.11 ± 9.29 years and an average T1DM duration of 12.40 ± 7.89 years. A significant increase in 25(OH)D levels (25.48 ± 6.29 versus 50.35 ± 24.2 ng/ml, p < 0.001) was observed, associated with a reduction in 24h albuminuria levels (84.37 ± 67.21 versus 60.6 ± 67.6 mg/24 h, p < 0.004). However, a slight increase in serum creatinine (0.76 ± 0.24 versus 0.81 ± 0.17 mg/dl, p = 0.091) and a reduction in GFR (114.11 ± 23.84 versus 106.35 ± 16.57) were noted. Six participants (6/17; 35%) with microalbuminuria progressed to normoalbuminuria, but slight changes in creatinine (0.66 ± 0.16 versus 0.76 ± 0.15 mg/dl, p = 0.015) and GFR (120 ± 22 versus 104 ± 21.8 ml/min/m², p = 0.015) were observed in this subgroup. Additionally, this subgroup had a shorter duration of T1DM compared to others (9.58 ± 5.73 versus 13.94 ± 8.71 years). Therefore, the results of this trial suggest that high-dose VD supplementation may reduce UAE and hyperfiltration in this population with T1DM and DKD, particularly in those with a shorter duration of T1DM.Acesso AbertoDiabetes mellitus tipo 1Doença renal do diabetesVitamina DType 1 diabetesDiabetic kidney diseaseVitamin DCNPQ::CIENCIAS MEDICAS::MEDICINATrabalho de Curso - Graduação - Monografia