The “Dose-Effect” Relationship Between 25-Hydroxyvitamin D and Muscle Strength in Hemodialysis Patients Favors a Normal Threshold of 30 ng/mL for Plasma 25-Hydroxyvitamin D

Bataille, Stanislas; Landrier, Jean‐François; Astier, Julien; Giaime, Philippe; Sampol, J.; Sichez, Hélène; Ollier, Jacques; Gugliotta, Jean; Serveaux, Marianne; Cohen, Julien; Darmon, Patrice

doi:10.1053/j.jrn.2015.08.007

Cited by 30 publications

(36 citation statements)

References 26 publications

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“…Surprisingly, protein intake did not show a statistically significant correlation with HGS, but it contributed to explain changes in HGS in men. Similar to our results, Bataille et al associated HGS and nPCR in a multivariate analysis including several clinical parameters and did not find any significant association. Nonetheless, one of the most important factors to preserve muscle mass is protein intake .…”

Section: Discussionsupporting

confidence: 91%

“…In patients undergoing peritoneal dialysis, this correlation has also been described . Most studies that suggest that serum albumin level is associated with HGS did not differentiate data between sexes as we have done in our study . Beberashvili et al found a positive and statistically significant correlation between serum albumin level and HGS in both sexes in HD elderly patients.…”

Section: Discussionsupporting

confidence: 60%

“…In previous studies, apart from age, sex, nPCR, and LTM, other parameters have been associated with HGS such as serum albumin level, transthyretin, predialysis creatinine, and predialysis urea. 28 In summary, MS is not only about muscle size; other entities may be associated, such as age, sex, biochemical parameters, and OH. 2 Comparing our predictive models with the literature, we observed that the previous authors just included body composition parameters and demographic characteristics.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Body Composition and Nutrition Parameters in Handgrip Strength: Are There Differences by Sex in Hemodialysis Patients?

Garagarza¹,

Flores

Valente³

2017

Nut in Clin Prac

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Background: Hemodialysis (HD) patients are vulnerable to multiple metabolic and nutrition derangements, leading to changes in body composition. Handgrip strength (HGS) has been used as a nutrition marker. We aimed to evaluate the relationship between HGS and lean tissue mass (LTM) with several parameters in HD patients and develop HGS predictive equations. Methods: Cross‐sectional study with 155 patients in HD treatment for ≥3 months. Body composition was assessed through bioimpedance spectroscopy. HGS was measured with a hydraulic hand dynamometer. Biochemical parameters were evaluated. Data were analyzed by sex. Results: Ninety‐four were men, and mean age was 64.4 ± 14.7 years. We found positive correlation of HGS with LTM, lean tissue index, and body cell mass and negative correlation between HGS, age, and overhydration in both sexes. Serum albumin level presented a positive correlation and magnesium a negative correlation with HGS only in men. The LTM presented a positive correlation with protein intake, serum albumin level, and body cell mass and a negative correlation with age in both groups. A significant positive correlation with magnesium and a negative correlation with overhydration were observed in men. The predictability of the models was R2 = 0.618 for men and R2 = 0.500 for women. Conclusion: HGS is highly correlated with LTM, and both differ between sexes and are, therefore, differently correlated with the parameters studied. Body composition, overhydration, and some biochemical parameters explain changes in HGS. Predictive models including body composition and biochemical parameters may explain at least 50% of the variance of HGS.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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Influence of Body Composition and Nutrition Parameters in Handgrip Strength: Are There Differences by Sex in Hemodialysis Patients?

Garagarza¹,

Flores

Valente³

2017

Nut in Clin Prac

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“…Low 25(OH)D has been associated with muscle weakness [35] and risk of falls [36]. Boudville et al reported that 25(OH)D deficiency is associated with muscular weakness and falls in dialysis patients, but with a J curve and maximal benefit in the range between 24 and 44 ng/mL of serum 25(OH)D levels [36].…”

Section: Consequences Of Low Serum 25(oh)d Levels In Ckd and Dialymentioning

confidence: 99%

Vitamin D in Chronic Kidney Disease and Dialysis Patients

2017

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Vitamin D deficiency (<20 ng/mL) and insufficiency (20–29 ng/mL) are common among patients with chronic kidney disease (CKD) or undergoing dialysis. In addition to nutritional and sunlight exposure deficits, factors that affect vitamin D deficiency include race, sex, age, obesity and impaired vitamin D synthesis and metabolism. Serum 1,25(OH)2D levels also decrease progressively because of 25(OH)D deficiency, together with impaired availability of 25(OH)D by renal proximal tubular cells, high fibroblast growth factor (FGF)-23 and decreased functional renal tissue. As in the general population, this condition is associated with increased morbidity and poor outcomes. Together with the progressive decline of serum calcitriol, vitamin D deficiency leads to secondary hyperparathyroidism (SHPT) and its complications, tertiary hyperparathyroidism and hypercalcemia, which require surgical parathyroidectomy or calcimimetics. Kidney Disease Outcomes Quality Initiative (KDOQI) and Kidney Disease Improving Global Outcomes (KDIGO) experts have recognized that vitamin D insufficiency and deficiency should be avoided in CKD and dialysis patients by using supplementation to prevent SHPT. Many vitamin D supplementation regimens using either ergocalciferol or cholecalciferol daily, weekly or monthly have been reported. The benefit of native vitamin D supplementation remains debatable because observational studies suggest that vitamin D receptor activator (VDRA) use is associated with better outcomes and it is more efficient for decreasing the serum parathormone (PTH) levels. Vitamin D has pleiotropic effects on the immune, cardiovascular and neurological systems and on antineoplastic activity. Extra-renal organs possess the enzymatic capacity to convert 25(OH)D to 1,25(OH)2D. Despite many unanswered questions, much data support vitamin D use in renal patients. This article emphasizes the role of native vitamin D replacement during all-phases of CKD together with VDRA when SHPT persists.

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“…Souza et al did not find significant difference in 25(OH)-VD levels in patients with CKD and sarcopenia compared to those non-sarcopenic [100]. In patients with end stage renal failure, low 25(OH)-VD has also been associated with muscle weakness and risk of falls, but the evidence to support these associations is limited to small observational studies [101,102]. …”

Section: Vd and Ckd: Human Studiesmentioning

confidence: 99%

Vitamin D Deficiency in Chronic Kidney Disease: Recent Evidence and Controversies

Gois

Wolley

Ranganathan

et al. 2018

IJERPH

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Vitamin D (VD) is a pro-hormone essential for life in higher animals. It is present in few types of foods and is produced endogenously in the skin by a photochemical reaction. The final step of VD activation occurs in the kidneys involving a second hydroxylation reaction to generate the biologically active metabolite 1,25(OH)2-VD. Extrarenal 1α-hydroxylation has also been described to have an important role in autocrine and paracrine signaling. Vitamin D deficiency (VDD) has been in the spotlight as a major public healthcare issue with an estimated prevalence of more than a billion people worldwide. Among individuals with chronic kidney disease (CKD), VDD prevalence has been reported to be as high as 80%. Classically, VD plays a pivotal role in calcium and phosphorus homeostasis. Nevertheless, there is a growing body of evidence supporting the importance of VD in many vital non-skeletal biological processes such as endothelial function, renin-angiotensin-aldosterone system modulation, redox balance and innate and adaptive immunity. In individuals with CKD, VDD has been associated with albuminuria, faster progression of kidney disease and increased all-cause mortality. Recent guidelines support VD supplementation in CKD based on extrapolation from cohorts conducted in the general population. In this review, we discuss new insights on the multifactorial pathophysiology of VDD in CKD as well as how it may negatively modulate different organs and systems. We also critically review the latest evidence and controversies of VD monitoring and supplementation in CKD patients.

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The “Dose-Effect” Relationship Between 25-Hydroxyvitamin D and Muscle Strength in Hemodialysis Patients Favors a Normal Threshold of 30 ng/mL for Plasma 25-Hydroxyvitamin D

Cited by 30 publications

References 26 publications

Influence of Body Composition and Nutrition Parameters in Handgrip Strength: Are There Differences by Sex in Hemodialysis Patients?

Influence of Body Composition and Nutrition Parameters in Handgrip Strength: Are There Differences by Sex in Hemodialysis Patients?

Vitamin D in Chronic Kidney Disease and Dialysis Patients

Vitamin D Deficiency in Chronic Kidney Disease: Recent Evidence and Controversies

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