Introduction:
Left ventricular remodeling in individuals with impaired renal function is associated with adverse cardiovascular outcomes. Vitamin D deficiency (VDD) may contribute to remodeling, yet the interaction remains underexplored.

Aim:
The aim of this review was to evaluate the relationship between serum vitamin D levels and left ventricular remodeling.

Material and methods:
Relevant records indexed in Scopus, PubMed, Web of Science, Europe PMC, and Scilit were identified using predetermined terms. Observational studies reporting the relationship between circulating vitamin D levels and left ventricular remodeling in renal-impaired individuals were considered eligible for the review. Out of 4503 records, 6 studies (n = 3235 participants) met the inclusion criteria. Pairwise, single-arm, and dose-response meta-analyses were performed under a random-effects model.

Results and discussion:
The pooled analysis revealed that individuals with VDD had significantly higher left ventricular mass index (LVMI) (SMD = 0.69; 95%CI: 0.21–1.16; P = 0.005). A pooled correlation analysis demonstrated an inverse association between serum vitamin D and LVMI (r = –0.414; 95% CI: –0.48 to –0.34; P < 0.001). Significant heterogeneity was observed in the association analysis (I² = 89%; P < 0.001), but not in the correlation analysis (I² = 6%; P = 0.30). The correlation between serum vitamin D levels and LVMI exhibited a significant J-shaped pattern, with the optimal maintenance level identified as above 46.26 ng/mL.

Conclusions:
Serum vitamin D levels are inversely associated with LVMI in renal-impaired individuals, suggesting that VDD contributes to adverse cardiac remodeling.