Vitamin D Metabolic Ratio and Risks of Death and CKD Progression.

kidney mortality vitamin D

Journal

Kidney international reports
ISSN: 2468-0249
Titre abrégé: Kidney Int Rep
Pays: United States
ID NLM: 101684752

Informations de publication

Date de publication:
Nov 2019
Historique:
received: 14 05 2019
revised: 15 08 2019
accepted: 19 08 2019
entrez: 1 1 2020
pubmed: 1 1 2020
medline: 1 1 2020
Statut: epublish

Résumé

Assessment of impaired vitamin D metabolism is limited by lack of functional measures. CYP24A1-mediated vitamin D clearance, calculated as the ratio of serum 24,25-dihydroxyvitamin D3 to 25-hydroxyvitamin D3 (the vitamin D metabolic ratio, VDMR), is induced by 1,25-dihydroxyvitamin D and may assess tissue-level activity. We tested associations of the VDMR with risks of death and progression to end-stage renal disease (ESRD) in patients with chronic kidney disease (CKD). We studied participants from the Chronic Renal Insufficiency Cohort (CRIC), which included a random subset of 1080 CRIC participants plus additional participants who experienced ESRD or died (case cohort study design). Serum 24,25-dihydroxyvitamin D3 and 25-hydroxyvitamin D3 was measured 1 year after enrollment. The primary outcomes included death and progression to ESRD. Using inverse probability weighting, we tested associations of VDMR (24,25[OH] There were a total of 708 ESRD events and 650 deaths events over mean (SD) follow-up periods of 4.9 (2.9) years and 6.5 (2.5) years, respectively. Lower VDMR was associated with increased risk of ESRD prior to adjusting for kidney function (hazard ratio [HR], 1.80 per 20 pg/ng lower VDMR; 95% confidence interval [CI], 1.56-2.08), but not with adjustment for kidney function (HR, 0.94 per 20 pg/ng; 95% CI, 0.81-1.10). Lower VDMR was associated with modestly increased mortality risk, including adjustment for kidney function (HR, 1.18 per 20 pg/ng; 95% CI, 1.02-1.36). Lower VDMR, a measure of CYP24A1-mediated vitamin D clearance, was significantly associated with all-cause mortality but not with progression to ESRD in patients with CKD.

Identifiants

pubmed: 31891001
doi: 10.1016/j.ekir.2019.08.014
pii: S2468-0249(19)31470-6
pmc: PMC6933450
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1598-1607

Subventions

Organisme : NIDDK NIH HHS
ID : R01 DK072231
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002548
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK060963
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR024131
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR013987
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK061022
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000003
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000439
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR029879
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK061028
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000433
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK060984
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK061021
Pays : United States
Organisme : NIDDK NIH HHS
ID : U24 DK060990
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK060980
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000424
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR016500
Pays : United States
Organisme : NIGMS NIH HHS
ID : P20 GM109036
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK060902
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK099199
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK060990
Pays : United States

Investigateurs

Lawrence J Appel (LJ)
Harold I Feldman (HI)
Alan S Go (AS)
Jiang He (J)
John W Kusek (JW)
James P Lash (JP)
Panduranga S Rao (PS)
Mahboob Rahman (M)
Raymond R Townsend (RR)

Informations de copyright

© 2019 International Society of Nephrology. Published by Elsevier Inc.

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Auteurs

Nisha Bansal (N)

Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington, USA.

Ronit Katz (R)

Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington, USA.

Lawrence Appel (L)

Department of Medicine and Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA.

Michelle Denburg (M)

Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Harold Feldman (H)

University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Alan S Go (AS)

Kaiser Permanente Northern California, Oakland, California, USA.

Jiang He (J)

Division of Nephrology, Department of Medicine, Tulane University, New Orleans, Louisiana, USA.

Andrew Hoofnagle (A)

Division of Clinical Chemistry, University of Washington, Seattle, Washington, USA.

Tamara Isakova (T)

Division of Nephrology, Department of Medicine, Northwestern University, Evanston, Illinois, USA.

Bryan Kestenbaum (B)

Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington, USA.

John Kusek (J)

National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA.

James Lash (J)

Division of Nephrology, Department of Medicine, University of Chicago, Chicago, Illinois, USA.

Mary Leonard (M)

Division of Nephrology, Department of Pediatrics, Stanford University, Stanford, California, USA.

Mahboob Rahman (M)

Division of Nephrology, Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.

Cassianne Robinson-Cohen (C)

Division of Nephrology, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA.

Myles Wolf (M)

Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina, USA.

Dawei Xie (D)

Department of Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Leila Zelnick (L)

Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington, USA.

Ian H de Boer (IH)

Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington, USA.

Classifications MeSH