Association of kidney function, vitamin D deficiency, and circulating markers of mineral and bone disorders in CKD


Serval ID
Article: article from journal or magazin.
Association of kidney function, vitamin D deficiency, and circulating markers of mineral and bone disorders in CKD
Am J Kidney Dis
Urena-Torres P., Metzger M., Haymann  J. P., Karras A., Boffa  J. J., Flamant M., Vrtovsnik F., Gauci C., Froissart M., Houillier P., Stengel B.
Working group(s)
NephroTest Study Group
1523-6838 (Electronic) 0272-6386 (Linking)
Publication state
Issued date
Urena-Torres, Pablo
Metzger, Marie
Haymann, Jean Philippe
Karras, Alexandre
Boffa, Jean-Jacques
Flamant, Martin
Vrtovsnik, Francois
Gauci, Cedric
Froissart, Marc
Houillier, Pascal
Stengel, Benedicte
Research Support, Non-U.S. Gov't
2011/08/02 06:00
Am J Kidney Dis. 2011 Oct;58(4):544-53. doi: 10.1053/j.ajkd.2011.04.029. Epub 2011 Jul 31.
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.
Adult, Africa South of the Sahara/ethnology, Aged, Alkaline Phosphatase/blood, Biomarkers, Bone Diseases, Metabolic/blood/*epidemiology, Chronic Disease, Cohort Studies, Collagen Type I/blood, Comorbidity, Cross-Sectional Studies, France/epidemiology, Glomerular Filtration Rate, Humans, Hyperparathyroidism, Secondary/blood/epidemiology, Kidney/*physiopathology, Kidney Diseases/blood/*epidemiology/physiopathology, Middle Aged, Minerals/*metabolism, Orosomucoid/analysis, Peptides/blood, Prevalence, Prospective Studies, Vitamin D/analogs & derivatives/blood, Vitamin D Deficiency/blood/*epidemiology, West Indies/ethnology
Create date
03/03/2016 17:49
Last modification date
21/08/2019 6:35
Usage data