Biomarkers of Vitamin D Status and Risk of ESRD.

Pubmed ID: 26475393

Pubmed Central ID: PMC4724452

Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation

Publication Date: Feb. 1, 2016

MeSH Terms: Humans, Male, Female, Aged, Case-Control Studies, Risk Factors, Cohort Studies, Middle Aged, Prospective Studies, Follow-Up Studies, Kidney Failure, Chronic, Residence Characteristics, Vitamin D, Biomarkers, Vitamin D-Binding Protein

Grants: HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, HHSN268201100012C, R01 HL103706, U01DK085689, R01HL103706, R01 DK089174, R01DK089174, T32 HL007024, U01 DK085689, K24 DK106414, HHSN268201100009I, HHSN268201100005G, HHSN268201100008I, HHSN268201100011I, HHSN268201100005I, HHSN268201100007I, U01 DK085649

Authors: Levey AS, Coresh J, Vasan RS, Kimmel PL, Grams ME, Rebholz CM, Lutsey PL, Hoofnagle AN, Misialek JR, Inker LA, Selvin E, Hsu CY, Eckfeldt JH

Cite As: Rebholz CM, Grams ME, Lutsey PL, Hoofnagle AN, Misialek JR, Inker LA, Levey AS, Selvin E, Hsu CY, Kimmel PL, Vasan RS, Eckfeldt JH, Coresh J, Chronic Kidney Disease Biomarkers Consortium. Biomarkers of Vitamin D Status and Risk of ESRD. Am J Kidney Dis 2016 Feb;67(2):235-42. Epub 2015 Oct 23.

Studies:

Abstract

BACKGROUND: Disordered mineral metabolism is characteristic of decreased kidney function. However, the prospective associations between circulating levels of vitamin D binding protein, vitamin D, and end-stage renal disease (ESRD) have not been extensively evaluated in epidemiologic studies. STUDY DESIGN: Nested case-control study. SETTING & PARTICIPANTS: Middle-aged black and white men and women from 4 US communities. PREDICTORS: Baseline levels of vitamin D binding protein, 25-hydroxyvitamin D (25[OH]D), and 1,25-dihydroxyvitamin D (1,25[OH]2D) were measured in blood samples collected at study visit 4 (1996-1998) of the ARIC (Atherosclerosis Risk in Communities) Study. OUTCOME: ESRD cases (n=184) were identified through hospitalization diagnostic codes from 1996 to 2008 and were frequency matched to controls (n=251) on categories of estimated glomerular filtration rate, albuminuria, diabetes mellitus, sex, and race. MEASUREMENTS: Logistic regression was used to estimate the association between mineral metabolism biomarkers (vitamin D binding protein, 25(OH)D, and 1,25(OH)2D) and incident ESRD, adjusting for age, sex, race, estimated glomerular filtration rate, albuminuria, diabetes mellitus, hypertension, education, specimen type, and serum levels of calcium, phosphate, and parathyroid hormone. RESULTS: Higher vitamin D binding protein levels were associated with elevated risk for incident ESRD (OR, 1.76; 95% CI, 1.22-2.54; P=0.003). Higher free and bioavailable 25(OH)D levels were associated with reduced risk for incident ESRD (ORs of 0.65 [95% CI, 0.46-0.92; P=0.02] and 0.63 [95% CI, 0.43-0.91; P=0.02] for free and bioavailable 25[OH]D, respectively). There was no association between ESRD and overall levels of 25(OH)D (OR, 0.83; 95% CI, 0.58-1.19; P=0.3) or 1,25(OH)2D (OR, 0.73; 95% CI, 0.48-1.13; P=0.2). LIMITATIONS: Lack of direct measurement of free and bioavailable vitamin D. CONCLUSIONS: In the general population, blood levels of vitamin D binding protein were positively associated and blood levels of free and bioavailable 25(OH)D were inversely associated with new-onset ESRD during follow-up.