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Association of kidney function, vitamin D deficiency, and circulating markers of mineral and bone disorders in CKD.
Am J Kidney Dis. 2011 Oct; 58(4):544-53.AJ

Abstract

BACKGROUND

Vitamin D (25 hydroxyvitamin D [25(OH)D]) deficiency is common in patients with chronic kidney disease (CKD). Neither the relation of this deficiency to the decrease in glomerular filtration rate (GFR) nor the effects on CKD mineral and bone disorders (MBD) are clearly established.

STUDY DESIGN

Cross-sectional analysis of baseline data from a prospective cohort, the NephroTest Study.

SETTING & PARTICIPANTS

1,026 adult patients with all-stage CKD not on dialysis therapy or receiving vitamin D supplementation.

PREDICTORS

For part 1, measured GFR (mGFR) using (51)Cr-EDTA renal clearance; for part 2, 25(OH)D deficiency at <15 ng/mL.

OUTCOMES & MEASUREMENTS

For part 1, 25(OH)D deficiency and several circulating MBD markers; for part 2, circulating MBD markers.

RESULTS

For part 1, the prevalence of 25(OH)D deficiency was associated inversely with mGFR, ranging from 28%-51% for mGFR ≥60-<15 mL/min/1.73 m(2). It was higher in patients of African origin; those with obesity, diabetes, hypertension, macroalbuminuria, and hypoalbuminemia; and during winter. After adjusting for these factors, ORs for 25(OH)D deficiency increased from 1.4 (95% CI, 0.9-2.3) to 1.4 (95% CI, 0.9-2.1), 1.7 (95% CI, 1.1-2.7), and 1.9 (95% CI, 1.1-3.6) as mGFR decreased from 45-59 to 30-44, 15-29, and <15 (reference, ≥60) mL/min/1.73 m(2) (P for trend = 0.02). For part 2, 25(OH)D deficiency was associated with higher age-, sex-, and mGFR-adjusted ORs of ionized calcium level <1.10 mmol/L (2.6; 95% CI, 1.2-5.9), 1,25 dihydroxyvitamin D concentration <16.7 pg/mL (1.8; 95% CI, 1.3-2.4), hyperparathyroidism (1.8; 95% CI, 1.3-2.4), and serum C-terminal cross-linked collagen type I telopeptides concentration >1,000 pg/mL (1.6; 95% CI, 1.0-2.6). It was not associated with hyperphosphatemia (phosphate >1.38 mmol/L).

LIMITATIONS

Cross-sectional analysis of the data prevents causal inferences.

CONCLUSIONS

25(OH)D deficiency is related independently to impaired mGFR. Both mGFR decrease and 25(OH)D deficiency are associated with abnormal levels of circulating MBD biomarkers.

Authors+Show Affiliations

Nephrology Dialysis, Clinique du Landy, Saint Ouen, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21803465

Citation

Ureña-Torres, Pablo, et al. "Association of Kidney Function, Vitamin D Deficiency, and Circulating Markers of Mineral and Bone Disorders in CKD." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 58, no. 4, 2011, pp. 544-53.
Ureña-Torres P, Metzger M, Haymann JP, et al. Association of kidney function, vitamin D deficiency, and circulating markers of mineral and bone disorders in CKD. Am J Kidney Dis. 2011;58(4):544-53.
Ureña-Torres, P., Metzger, M., Haymann, J. P., Karras, A., Boffa, J. J., Flamant, M., Vrtovsnik, F., Gauci, C., Froissart, M., Houillier, P., & Stengel, B. (2011). Association of kidney function, vitamin D deficiency, and circulating markers of mineral and bone disorders in CKD. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 58(4), 544-53. https://doi.org/10.1053/j.ajkd.2011.04.029
Ureña-Torres P, et al. Association of Kidney Function, Vitamin D Deficiency, and Circulating Markers of Mineral and Bone Disorders in CKD. Am J Kidney Dis. 2011;58(4):544-53. PubMed PMID: 21803465.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of kidney function, vitamin D deficiency, and circulating markers of mineral and bone disorders in CKD. AU - Ureña-Torres,Pablo, AU - Metzger,Marie, AU - Haymann,Jean Philippe, AU - Karras,Alexandre, AU - Boffa,Jean-Jacques, AU - Flamant,Martin, AU - Vrtovsnik,François, AU - Gauci,Cédric, AU - Froissart,Marc, AU - Houillier,Pascal, AU - Stengel,Bénédicte, AU - ,, Y1 - 2011/07/31/ PY - 2011/01/13/received PY - 2011/04/26/accepted PY - 2011/8/2/entrez PY - 2011/8/2/pubmed PY - 2011/12/13/medline SP - 544 EP - 53 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 58 IS - 4 N2 - BACKGROUND: Vitamin D (25 hydroxyvitamin D [25(OH)D]) deficiency is common in patients with chronic kidney disease (CKD). Neither the relation of this deficiency to the decrease in glomerular filtration rate (GFR) nor the effects on CKD mineral and bone disorders (MBD) are clearly established. STUDY DESIGN: Cross-sectional analysis of baseline data from a prospective cohort, the NephroTest Study. SETTING & PARTICIPANTS: 1,026 adult patients with all-stage CKD not on dialysis therapy or receiving vitamin D supplementation. PREDICTORS: For part 1, measured GFR (mGFR) using (51)Cr-EDTA renal clearance; for part 2, 25(OH)D deficiency at <15 ng/mL. OUTCOMES & MEASUREMENTS: For part 1, 25(OH)D deficiency and several circulating MBD markers; for part 2, circulating MBD markers. RESULTS: For part 1, the prevalence of 25(OH)D deficiency was associated inversely with mGFR, ranging from 28%-51% for mGFR ≥60-<15 mL/min/1.73 m(2). It was higher in patients of African origin; those with obesity, diabetes, hypertension, macroalbuminuria, and hypoalbuminemia; and during winter. After adjusting for these factors, ORs for 25(OH)D deficiency increased from 1.4 (95% CI, 0.9-2.3) to 1.4 (95% CI, 0.9-2.1), 1.7 (95% CI, 1.1-2.7), and 1.9 (95% CI, 1.1-3.6) as mGFR decreased from 45-59 to 30-44, 15-29, and <15 (reference, ≥60) mL/min/1.73 m(2) (P for trend = 0.02). For part 2, 25(OH)D deficiency was associated with higher age-, sex-, and mGFR-adjusted ORs of ionized calcium level <1.10 mmol/L (2.6; 95% CI, 1.2-5.9), 1,25 dihydroxyvitamin D concentration <16.7 pg/mL (1.8; 95% CI, 1.3-2.4), hyperparathyroidism (1.8; 95% CI, 1.3-2.4), and serum C-terminal cross-linked collagen type I telopeptides concentration >1,000 pg/mL (1.6; 95% CI, 1.0-2.6). It was not associated with hyperphosphatemia (phosphate >1.38 mmol/L). LIMITATIONS: Cross-sectional analysis of the data prevents causal inferences. CONCLUSIONS: 25(OH)D deficiency is related independently to impaired mGFR. Both mGFR decrease and 25(OH)D deficiency are associated with abnormal levels of circulating MBD biomarkers. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/21803465/Association_of_kidney_function_vitamin_D_deficiency_and_circulating_markers_of_mineral_and_bone_disorders_in_CKD_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(11)01018-3 DB - PRIME DP - Unbound Medicine ER -