Vitamin D has been shown to have multiple pleiotropic effects beyond bone and mineral metabolism, with purported roles in cardiovascular disease, cancer, and host immunity. Vitamin D deficiency is common in patients with end-stage kidney disease (ESKD); however, current clinical practice has favored the use of the active hormone. Whether vitamin D deficiency should be corrected in patients with ESKD remains unclear, as few randomized trials have been conducted. In this systematic review, we summarize the current evidence examining whether vitamin D supplementation improves outcomes, beyond mineral metabolism, in patients with ESKD. Data from randomized controlled trials of adults with ESKD were obtained by searching Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the Web of Science Core Collection from inception to February 2023. Twenty-three trials composed of 2489 participants were identified for inclusion. Data were synthesized by two independent reviewers and summarized in tables organized by outcome. Outcomes included measures of mortality, cardiovascular disease, inflammation, muscle strength/function, nutrition, patient well-being, and outcomes specific to ESKD including erythropoietin usage, pruritus, and dialysis access maturation. The Cochrane risk of Bias Tool (RoB 2, 2019) was used to assess study quality. Overall, our findings indicate a minimal and varied benefit of native vitamin D supplementation. From the largest studies included, we determine that vitamin D has no demonstrated effect on patient-reported measures of well-being or utilization of erythropoietin, nor does it change levels of the inflammation biomarker C-reactive protein. Included trials were heterogeneous with regards to outcomes, and the majority studied small participant populations with a relatively short follow-up. We conclude that vitamin D supplementation corrects vitamin D deficiency and is safe and well-tolerated in humans with ESKD. However, it is not clear from clinical trials conducted to date that a causal pathway exists between 25(OH)D and pleiotropic effects that is responsive to vitamin D treatment.

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world. Emerging concepts like One Health, integrated care models for COPD, and associations between oral and respiratory health are innovative ways to approach COPD treatment. This study explored contemporary evidence on the inclusion of dental providers on interprofessional healthcare teams treating patients with COPD. The first objective was to explore the current state of interprofessional care for COPD, and the second objective was to explore dentistry used in interprofessional care. A rapid review was conducted from January–June 2020 using Scopus and PubMed. Upon assessing for duplication and relevance, 85 articles were included for Objective 1, and 194 for Objective 2. The literature suggests that when dental providers are included on interprofessional healthcare teams, treatment outcomes for patients with multi-morbid, chronic disease such as COPD, are improved. The papers collected for review suggest that educational and clinical programs should implement interprofessional collaboration when treating chronic diseases. Healthcare teams can utilize the expertise of professionals outside the traditional medical field to better understand patients’ needs. Healthcare administration should consider a One Health approach when developing COPD treatment guidelines. We believe our results are transferable to the Canadian healthcare system. The collaborative nature and holistic philosophy of a One Health approach provides a novel way to develop policies and procedures that can effectively address the burden of COPD.