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Biomarkers of Vitamin D Status and Risk of ESRD.

TitleBiomarkers of Vitamin D Status and Risk of ESRD.
Publication TypeJournal Article
Year of Publication2016
AuthorsRebholz CM, Grams ME, Lutsey PL, Hoofnagle AN, Misialek JR, Inker LA, Levey AS, Selvin E, Hsu C-Y, Kimmel PL, Vasan RS, Eckfeldt JH
Secondary AuthorsCoresh JJ
Corporate AuthorsChronic Kidney Disease Biomarkers Consortium
JournalAm J Kidney Dis
Volume67
Issue2
Pagination235-42
Date Published2016 Feb
ISSN1523-6838
KeywordsAged, Biomarkers, Case-Control Studies, Cohort Studies, Female, Follow-Up Studies, Humans, Kidney Failure, Chronic, Male, Middle Aged, Prospective Studies, Residence Characteristics, Risk Factors, Vitamin D, Vitamin D-Binding Protein
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.

DOI10.1053/j.ajkd.2015.08.026
Alternate JournalAm J Kidney Dis
PubMed ID26475393
PubMed Central IDPMC4724452
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
R01 HL103706 / HL / NHLBI NIH HHS / United States
U01DK085689 / DK / NIDDK NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
R01HL103706 / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
R01DK089174 / DK / NIDDK NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
U01 DK085649 / DK / NIDDK NIH HHS / United States
K24 DK106414 / DK / NIDDK NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
U01 DK085689 / DK / NIDDK NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
HHSN268201100006C / / PHS HHS / United States