Protective effects of vitamin D(3) (cholecalciferol) on vancomycin-induced oxidative nephrotoxic damage in rats

CONTEXT: Vancomycin (VCM), an important antibiotic against refractory infections, has been used to treat secondary infections in severe COVID-19 patients. Regrettably, VCM treatment has been associated with nephrotoxicity. Vitamin D(3) can prevent nephrotoxicity through its antioxidant effect. OBJECTIVE: This study tests the antioxidant effect of vitamin D(3) in the prevention of VCM-induced nephrotoxicity. MATERIALS AND METHODS: Wistar Albino rats (21) were randomly divided into 3 groups: (A) control; (B) VCM 300 mg/kg daily for 1 week; and (C) VCM plus vitamin D(3) 500 IU/kg daily for 2 weeks. All the rats were sacrificed and serum was separated to determine kidney function parameters. Their kidneys were also dissected for histological examination and for oxidative stress markers. RESULTS: Lipid peroxidation, creatinine, and urea levels decreased significantly (p < 0.0001) in the vitamin D(3)-treated group (14.46, 84.11, 36.17%, respectively) compared to the VCM group that was given VCM (MIC<2 μg/mL) only. A significant increase was observed in superoxide dismutase levels in the vitamin D(3)-treated group (p < 0.05) compared to rats without treatment. Furthermore, kidney histopathology of the rats treated with vitamin D(3) showed that dilatation, vacuolization and necrosis tubules decreased significantly (p < 0.05) compared with those in the VCM group. Glomerular injury, hyaline dystrophy, and inflammation improved significantly in the vitamin D(3) group (p < 0.001, p < 0.05, p < 0.05, respectively) compared with the VCM group. DISCUSSION AND CONCLUSIONS: Vitamin D(3) can prevent VCM nephrotoxicity. Therefore, the appropriate dose of this vitamin must be determined, especially for those infected with COVID-19 and receiving VCM, to manage their secondary infections.