Serum 25-Hydroxyvitamin D and Change in Estimated Glomerular Filtration Rate

Boer, Ian H. de; Katz, Ronit; Chonchol, Michel; Ix, Joachim H.; Sarnak, Mark J.; Shlipak, Michael G.; Siscovick, David S.; Kestenbaum, Bryan

doi:10.2215/cjn.02640311

Cited by 103 publications

(88 citation statements)

References 48 publications

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“…We also considered rapid eGFR decline, CKD incidence, and albuminuria incidence as dependent outcomes. Rapid eGFR decline was defined a priori an annual loss .3 ml/min per 1.73 m 2 according to previous reports (9,25). Incident CKD was defined as an eGFR,60 ml/min per 1.73 m 2 at follow-up among participants with eGFR$60 ml/min per 1.73 m 2 at baseline.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…Because it is not clear whether change in eGFR should be adjusted for baseline eGFR (28)(29)(30), models of change in eGFR without and with adjustment for the initial eGFR value are presented. De Boer and colleagues could not consider the effect of baseline albuminuria on the associations of 25(OH)D with change in eGFR (9). To fulfill this gap, we compared the association of 25(OH)D with change in eGFR with and without adjustment for baseline albuminuria.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…The Cardiovascular Health Study showed lower levels of serum 25(OH)D were associated with both increased annual loss in eGFR and increased risk of rapid eGFR decline (9). However, the analyses were not adjusted for baseline eGFR.…”

Section: Introductionmentioning

confidence: 99%

“…An inverse association of 25(OH)D levels with proteinuria has been reported (4)(5)(6), but the associations of 25(OH)D levels with eGFR and CKD stages are less clear (2,(7)(8)(9)(10). Most studies conducted so far were crosssectional and hence subject to temporality bias.…”

Section: Introductionmentioning

confidence: 99%

“…So far, three longitudinal studies have assessed the association of baseline circulating 25(OH)D with change in eGFR and incident CKD (9,14,15). The Cardiovascular Health Study showed lower levels of serum 25(OH)D were associated with both increased annual loss in eGFR and increased risk of rapid eGFR decline (9).…”

Section: Introductionmentioning

confidence: 99%

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Serum 25-Hydroxyvitamin D Level and Kidney Function Decline in a Swiss General Adult Population

Guessous

McClellan

Kleinbaum

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Molecular evidence suggests that levels of vitamin D are associated with kidney function loss. Still, population-based studies are limited and few have considered the potential confounding effect of baseline kidney function. This study evaluated the association of serum 25-hydroxyvitamin D with change in eGFR, rapid eGFR decline, and incidence of CKD and albuminuria.Design, setting, participants, & measurements Baseline (2003Baseline ( -2006 and 5.5-year follow-up data from a Swiss adult general population were used to evaluate the association of serum 25-hydroxyvitamin D with change in eGFR, rapid eGFR decline (annual loss .3 ml/min per 1.73 m 2 ), and incidence of CKD and albuminuria. Serum 25-hydroxyvitamin D was measured at baseline using liquid chromatography-tandem mass spectrometry. eGFR and albuminuria were collected at baseline and follow-up. Multivariate linear and logistic regression models were used considering potential confounding factors.Results Among the 4280 people included in the analysis, the mean6SD annual eGFR change was 20.5761.78 ml/min per 1.73 m 2 , and 287 (6.7%) participants presented rapid eGFR decline. Before adjustment for baseline eGFR, baseline 25-hydroxyvitamin D level was associated with both mean annual eGFR change and risk of rapid eGFR decline, independently of baseline albuminuria. Once adjusted for baseline eGFR, associations were no longer significant. For every 10 ng/ml higher baseline 25-hydroxyvitamin D, the adjusted mean annual eGFR change was 20.005 ml/min per 1.73 m 2 (95% confidence interval, 20.063 to 0.053; P=0.87) and the risk of rapid eGFR decline was null (odds ratio, 0.93; 95% confidence interval, 0.79 to 1.08; P=0.33). Baseline 25-hydroxyvitamin D level was not associated with incidence of CKD or albuminuria.Conclusions The association of 25-hydroxyvitamin D with eGFR decline is confounded by baseline eGFR. Sufficient 25-hydroxyvitamin D levels do not seem to protect from eGFR decline independently from baseline eGFR.

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Section: Statistical Analysesmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Serum 25-Hydroxyvitamin D Level and Kidney Function Decline in a Swiss General Adult Population

Guessous

McClellan

Kleinbaum

et al. 2015

Clinical Journal of the American Society of Nephrology

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Effect of Vitamin D and Omega-3 Fatty Acid Supplementation on Kidney Function in Patients With Type 2 Diabetes

Boer

Zelnick

Ruzinski

et al. 2019

JAMA

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101

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IMPORTANCE Chronic kidney disease (CKD) is a common complication of type 2 diabetes that can lead to end-stage kidney disease and is associated with high cardiovascular risk. Few treatments are available to prevent CKD in type 2 diabetes. OBJECTIVE To test whether supplementation with vitamin D 3 or omega-3 fatty acids prevents development or progression of CKD in type 2 diabetes. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial with a 2 × 2 factorial design conducted among 1312 adults with type 2 diabetes recruited between November 2011 and March 2014 from all 50 US states as an ancillary study to the Vitamin D and Omega-3 Trial (VITAL), coordinated by a single center in Massachusetts. Follow-up was completed in December 2017. INTERVENTIONS Participants were randomized to receive vitamin D 3 (2000 IU/d) and omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid; 1 g/d) (n = 370), vitamin D 3 and placebo (n = 333), placebo and omega-3 fatty acids (n = 289), or 2 placebos (n = 320) for 5 years. MAIN OUTCOMES AND MEASURESThe primary outcome was change in glomerular filtration rate estimated from serum creatinine and cystatin C (eGFR) from baseline to year 5. RESULTS Among 1312 participants randomized (mean age, 67.6 years; 46% women; 31% of racial or ethnic minority), 934 (71%) completed the study. Baseline mean eGFR was 85.8 (SD, 22.1) mL/min/1.73 m 2 . Mean change in eGFR from baseline to year 5 was −12.3 (95% CI, −13.4 to −11.2) mL/min/1.73 m 2 with vitamin D 3 vs −13.1 (95% CI, −14.2 to −11.9) mL/min/1.73 m 2 with placebo (difference, 0.9 [95% CI, −0.7 to 2.5] mL/min/1.73 m 2 ). Mean change in eGFR was −12.2 (95% CI, −13.3 to −11.1) mL/min/1.73 m 2 with omega-3 fatty acids vs −13.1 (95% CI, −14.2 to −12.0) mL/min/1.73 m 2 with placebo (difference, 0.9 [95% CI, −0.7 to 2.6] mL/min/1.73 m 2 ). There was no significant interaction between the 2 interventions. Kidney stones occurred among 58 participants (n = 32 receiving vitamin D 3 and n = 26 receiving placebo) and gastrointestinal bleeding among 45 (n = 28 receiving omega-3 fatty acids and n = 17 receiving placebo).CONCLUSIONS AND RELEVANCE Among adults with type 2 diabetes, supplementation with vitamin D 3 or omega-3 fatty acids, compared with placebo, resulted in no significant difference in change in eGFR at 5 years. The findings do not support the use of vitamin D or omega-3 fatty acid supplementation for preserving kidney function in patients with type 2 diabetes.

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