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Plasma Vitamin D Level and Change in Albuminuria and eGFR According to Sodium Intake.
Clin J Am Soc Nephrol. 2015 Dec 07; 10(12):2119-27.CJ

Abstract

BACKGROUND AND OBJECTIVES

Low circulating 25-hydroxyvitamin D [25(OH)D] and high sodium intake are both associated with progressive albuminuria and renal function loss in CKD. Both vitamin D and sodium intake interact with the renin-angiotensin-aldosterone system. We investigated whether plasma 25(OH)D or 1,25-dihydroxyvitamin D [1,25(OH)2D] is associated with developing increased albuminuria or reduced renal function and whether these associations depend on sodium intake.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

Baseline plasma 25(OH)D and 1,25(OH)2D were measured by liquid chromatography tandem mass spectrometry, and sodium intake was assessed by 24-hour urine collections in the general population-based Prevention of Renal and Vascular End-Stage Disease cohort (n=5051). Two primary outcomes were development of urinary albumin excretion >30 mg/24 h and eGFR (creatinine/cystatin C-based CKD Epidemiology Collaboration) <60 ml/min per 1.73 m(2). Participants with CKD at baseline were excluded. In Cox regression analyses, we assessed associations of vitamin D with developing increased albuminuria or reduced eGFR and potential interaction with sodium intake.

RESULTS

During a median follow-up of 10.4 (6.2-11.4) years, 641 (13%) participants developed increased albuminuria, and 268 (5%) participants developed reduced eGFR. Plasma 25(OH)D was inversely associated with increased albuminuria (fully adjusted hazard ratio [HR] per SD higher, 0.86; 95% confidence interval [95% CI], 0.78 to 0.95; P=0.003) but not reduced eGFR (HR, 0.99; 95% CI, 0.87 to 1.12; P=0.85). There was interaction between 25(OH)D and sodium intake for risk of developing increased albuminuria (P interaction =0.03). In participants with high sodium intake, risk of developing increased albuminuria was inversely associated with 25(OH)D (lowest versus highest quartile: adjusted HR, 1.81; 95% CI, 1.20 to 2.73, P<0.01), whereas this association was nonsignificant in participants with low sodium intake (HR, 1.29; 95% CI, 0.94 to 1.77; P=0.12). Plasma 1,25(OH)2D was not significantly associated with increased albuminuria or reduced eGFR.

CONCLUSIONS

Low plasma 25(OH)D is associated with higher risk of developing increased albuminuria, particularly in individuals with high sodium intake, but not of developing reduced eGFR. Plasma 1,25(OH)2D is not associated with risk of developing increased albuminuria or reduced eGFR.

Authors+Show Affiliations

Department of Internal Medicine, Division of Nephrology, and.Departments of Clinical Pharmacy and Pharmacology and.Department of Internal Medicine, Division of Nephrology, and Top Institute Food and Nutrition, Wageningen, The Netherlands.Department of Internal Medicine, Division of Nephrology, and.Department of Internal Medicine, Division of Nephrology, and.Department of Internal Medicine, Division of Nephrology, and.Laboratory Medicine, University of Groningen, University Medical Center Groningen, The Netherlands; and.Departments of Clinical Pharmacy and Pharmacology and.Department of Internal Medicine, Division of Nephrology, and Top Institute Food and Nutrition, Wageningen, The Netherlands.Department of Internal Medicine, Division of Nephrology, and m.h.de.borst@umcg.nl.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

26450935

Citation

Keyzer, Charlotte A., et al. "Plasma Vitamin D Level and Change in Albuminuria and eGFR According to Sodium Intake." Clinical Journal of the American Society of Nephrology : CJASN, vol. 10, no. 12, 2015, pp. 2119-27.
Keyzer CA, Lambers-Heerspink HJ, Joosten MM, et al. Plasma Vitamin D Level and Change in Albuminuria and eGFR According to Sodium Intake. Clin J Am Soc Nephrol. 2015;10(12):2119-27.
Keyzer, C. A., Lambers-Heerspink, H. J., Joosten, M. M., Deetman, P. E., Gansevoort, R. T., Navis, G., Kema, I. P., de Zeeuw, D., Bakker, S. J., & de Borst, M. H. (2015). Plasma Vitamin D Level and Change in Albuminuria and eGFR According to Sodium Intake. Clinical Journal of the American Society of Nephrology : CJASN, 10(12), 2119-27. https://doi.org/10.2215/CJN.03830415
Keyzer CA, et al. Plasma Vitamin D Level and Change in Albuminuria and eGFR According to Sodium Intake. Clin J Am Soc Nephrol. 2015 Dec 7;10(12):2119-27. PubMed PMID: 26450935.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma Vitamin D Level and Change in Albuminuria and eGFR According to Sodium Intake. AU - Keyzer,Charlotte A, AU - Lambers-Heerspink,Hiddo J, AU - Joosten,Michel M, AU - Deetman,Petronella E, AU - Gansevoort,Ron T, AU - Navis,Gerjan, AU - Kema,Ido P, AU - de Zeeuw,Dick, AU - Bakker,Stephan J L, AU - de Borst,Martin H, AU - ,, Y1 - 2015/10/08/ PY - 2015/04/07/received PY - 2015/09/03/accepted PY - 2015/10/10/entrez PY - 2015/10/10/pubmed PY - 2016/9/14/medline KW - 1,25-dihydroxyvitamin D KW - 25-hydroxyvitamin D KW - albuminuria KW - chronic kidney disease KW - creatinine KW - cystatin C KW - diet KW - eGFR KW - follow-up studies KW - humans KW - sodium KW - vitamin D SP - 2119 EP - 27 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 10 IS - 12 N2 - BACKGROUND AND OBJECTIVES: Low circulating 25-hydroxyvitamin D [25(OH)D] and high sodium intake are both associated with progressive albuminuria and renal function loss in CKD. Both vitamin D and sodium intake interact with the renin-angiotensin-aldosterone system. We investigated whether plasma 25(OH)D or 1,25-dihydroxyvitamin D [1,25(OH)2D] is associated with developing increased albuminuria or reduced renal function and whether these associations depend on sodium intake. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Baseline plasma 25(OH)D and 1,25(OH)2D were measured by liquid chromatography tandem mass spectrometry, and sodium intake was assessed by 24-hour urine collections in the general population-based Prevention of Renal and Vascular End-Stage Disease cohort (n=5051). Two primary outcomes were development of urinary albumin excretion >30 mg/24 h and eGFR (creatinine/cystatin C-based CKD Epidemiology Collaboration) <60 ml/min per 1.73 m(2). Participants with CKD at baseline were excluded. In Cox regression analyses, we assessed associations of vitamin D with developing increased albuminuria or reduced eGFR and potential interaction with sodium intake. RESULTS: During a median follow-up of 10.4 (6.2-11.4) years, 641 (13%) participants developed increased albuminuria, and 268 (5%) participants developed reduced eGFR. Plasma 25(OH)D was inversely associated with increased albuminuria (fully adjusted hazard ratio [HR] per SD higher, 0.86; 95% confidence interval [95% CI], 0.78 to 0.95; P=0.003) but not reduced eGFR (HR, 0.99; 95% CI, 0.87 to 1.12; P=0.85). There was interaction between 25(OH)D and sodium intake for risk of developing increased albuminuria (P interaction =0.03). In participants with high sodium intake, risk of developing increased albuminuria was inversely associated with 25(OH)D (lowest versus highest quartile: adjusted HR, 1.81; 95% CI, 1.20 to 2.73, P<0.01), whereas this association was nonsignificant in participants with low sodium intake (HR, 1.29; 95% CI, 0.94 to 1.77; P=0.12). Plasma 1,25(OH)2D was not significantly associated with increased albuminuria or reduced eGFR. CONCLUSIONS: Low plasma 25(OH)D is associated with higher risk of developing increased albuminuria, particularly in individuals with high sodium intake, but not of developing reduced eGFR. Plasma 1,25(OH)2D is not associated with risk of developing increased albuminuria or reduced eGFR. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/26450935/Plasma_Vitamin_D_Level_and_Change_in_Albuminuria_and_eGFR_According_to_Sodium_Intake_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=26450935 DB - PRIME DP - Unbound Medicine ER -