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Serum 25-hydroxyvitamin D and change in estimated glomerular filtration rate.

TitleSerum 25-hydroxyvitamin D and change in estimated glomerular filtration rate.
Publication TypeJournal Article
Year of Publication2011
Authorsde Boer, IH, Katz, R, Chonchol, M, Ix, JH, Sarnak, MJ, Shlipak, MG, Siscovick, DS, Kestenbaum, B
JournalClin J Am Soc Nephrol
Volume6
Issue9
Pagination2141-9
Date Published2011 Sep
ISSN1555-905X
KeywordsAged, Female, Glomerular Filtration Rate, Humans, Kidney Diseases, Male, Prospective Studies, Vitamin D
Abstract<p><b>BACKGROUND AND OBJECTIVES: </b>Mounting evidence suggests that 1,25-dihydroxyvitamin D prevents the progression of chronic kidney disease (CKD). It is not clear whether "nutritional" forms of vitamin D affect GFR.</p><p><b>DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: </b>We tested whether serum 25-hydroxyvitamin D concentration (25(OH)D), a measure of total vitamin D intake from cutaneous synthesis and dietary consumption, is associated with loss of estimated GFR among 1705 older adults with predominantly normal baseline kidney function participating in the Cardiovascular Health Study. Baseline 25(OH)D was measured by HPLC-tandem mass spectrometry. GFR was estimated at baseline and 4 years later using the CKD-EPI formula, with rapid GFR loss defined as 12 ml/min per 1.73 m(2) or more over 4 years.</p><p><b>RESULTS: </b>Rapid GFR loss was observed for 207 participants (12%). Each 10 ng/ml lower 25(OH)D was associated with a 25% greater risk of rapid GFR loss (95% confidence interval [CI] 5%, 49%, P = 0.01), adjusting for potential confounding characteristics. Compared with 25(OH)D ≥30 ng/ml, 25(OH)D concentrations 15 to 29 ng/ml and <15 ng/ml were associated with 29% (95% CI -13%, 91%) and 68% (95% CI 1%, 177%) greater adjusted risks of rapid GFR loss, respectively. Magnitudes of association were largest among participants with diabetes.</p><p><b>RESULTS: </b>were similar evaluating a composite outcome of rapid GFR loss, end stage renal disease, and death. Conclusions Insufficient 25(OH)D may be a modifiable risk factor for early GFR loss. We recommend clinical trials to determine whether vitamin D supplementation prevents the development and progression of CKD.</p>
DOI10.2215/CJN.02640311
Alternate JournalClin J Am Soc Nephrol
PubMed ID21836148
PubMed Central IDPMC3359004
Grant ListR01 DK087726 / DK / NIDDK NIH HHS / United States
R01AG027002 / AG / NIA NIH HHS / United States
R01 DK088762 / DK / NIDDK NIH HHS / United States
U01 HL080295 / HL / NHLBI NIH HHS / United States
R01HL096875 / HL / NHLBI NIH HHS / United States
N01 HC015103 / HC / NHLBI NIH HHS / United States
R01HL084443 / HL / NHLBI NIH HHS / United States
KL2RR025015 / RR / NCRR NIH HHS / United States
N01HC55222 / HL / NHLBI NIH HHS / United States
N01-HC-85086 / HC / NHLBI NIH HHS / United States
N01HC85086 / HL / NHLBI NIH HHS / United States
N01 HC-55222 / HC / NHLBI NIH HHS / United States
N01-HC-75150 / HC / NHLBI NIH HHS / United States
R01DK087726 / DK / NIDDK NIH HHS / United States
R01 HL084443 / HL / NHLBI NIH HHS / United States
R01 AG027002 / AG / NIA NIH HHS / United States
N01HC75150 / HL / NHLBI NIH HHS / United States
KL2 RR025015 / RR / NCRR NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
N01HC85079 / HL / NHLBI NIH HHS / United States
N01 HC045133 / HC / NHLBI NIH HHS / United States
R01 HL096875 / HL / NHLBI NIH HHS / United States
N01 HC035129 / HC / NHLBI NIH HHS / United States