Patricia L Gordon1, Julie W Doyle, Kirsten L Johansen. 1. Division of Nephrology, Department of Medicine, University of California, San Francisco, California 94121, USA. patricia.gordon@ucsf.edu
Abstract
BACKGROUND: Declines in 1,25-dihydroxyvitamin D (1,25(OH)₂D) levels and physical functioning follow the course of chronic kidney disease (CKD). Although the molecular actions of vitamin D in skeletal muscle are well known, and muscle weakness and atrophy are observed in vitamin D-deficient states, there is little information regarding vitamin D and muscle function and size in CKD. OBJECTIVE: To examine associations of vitamin D with physical performance (PF) and muscle size. DESIGN: Cross-sectional. SETTING: CKD clinic. SUBJECTS:Twenty-six patients (61 ± 13 years, 92% men) with CKD stage 3 or 4. MAIN OUTCOME MEASURES: Gait speed, 6-minute walk, sit-to-stand time, 1-legged balance, and thigh muscle cross-sectional area (MCSA), measured by magnetic resonance imaging (MRI). RESULTS: Overall, 73% were 25-hydroxyvitamin D (25(OH)D) deficient (n = 10) or insufficient (n = 9) (Kidney Disease Outcomes Quality Initiative guidelines). 25(OH)D level was associated with normal gait speed only (r = 0.41, P = .04). Normal and fast gait speed, the distance walked in 6 minutes, and sit-to-stand time were best explained by 1,25(OH)₂D and body mass index (P < .05 for all) and 1-legged stand by 1,25(OH)₂D (r = 0.40, P < .05) only. There were no associations of age, estimated glomerular filtration rate (eGFR), intact parathyroid hormone (iPTH), or albumin with any PF measures. MCSA was associated with eGFR (r = 0.54, P < .01) only. Variance in MCSA was best explained by a model containing 1,25(OH)₂D, plasma Ca²⁺, and daily physical activity (by accelerometry) (P < .05 for all). Once these variables were in the model, there was no contribution of eGFR. CONCLUSION: These results suggest that 1,25(OH)₂D is a determinant of PF and muscle size in patients with stage 3 and 4 CKD.
RCT Entities:
BACKGROUND: Declines in 1,25-dihydroxyvitamin D (1,25(OH)₂D) levels and physical functioning follow the course of chronic kidney disease (CKD). Although the molecular actions of vitamin D in skeletal muscle are well known, and muscle weakness and atrophy are observed in vitamin D-deficient states, there is little information regarding vitamin D and muscle function and size in CKD. OBJECTIVE: To examine associations of vitamin D with physical performance (PF) and muscle size. DESIGN: Cross-sectional. SETTING: CKD clinic. SUBJECTS: Twenty-six patients (61 ± 13 years, 92% men) with CKD stage 3 or 4. MAIN OUTCOME MEASURES: Gait speed, 6-minute walk, sit-to-stand time, 1-legged balance, and thigh muscle cross-sectional area (MCSA), measured by magnetic resonance imaging (MRI). RESULTS: Overall, 73% were 25-hydroxyvitamin D (25(OH)D) deficient (n = 10) or insufficient (n = 9) (Kidney Disease Outcomes Quality Initiative guidelines). 25(OH)D level was associated with normal gait speed only (r = 0.41, P = .04). Normal and fast gait speed, the distance walked in 6 minutes, and sit-to-stand time were best explained by 1,25(OH)₂D and body mass index (P < .05 for all) and 1-legged stand by 1,25(OH)₂D (r = 0.40, P < .05) only. There were no associations of age, estimated glomerular filtration rate (eGFR), intact parathyroid hormone (iPTH), or albumin with any PF measures. MCSA was associated with eGFR (r = 0.54, P < .01) only. Variance in MCSA was best explained by a model containing 1,25(OH)₂D, plasma Ca²⁺, and daily physical activity (by accelerometry) (P < .05 for all). Once these variables were in the model, there was no contribution of eGFR. CONCLUSION: These results suggest that 1,25(OH)₂D is a determinant of PF and muscle size in patients with stage 3 and 4 CKD.
Authors: Christopher W McIntyre; Nicholas M Selby; Mhairi Sigrist; Lyndsay E Pearce; Thomas H Mercer; Patrick F Naish Journal: Nephrol Dial Transplant Date: 2006-02-27 Impact factor: 5.992
Authors: Yan G Zorbas; Vassily J Kakurin; Sergei D Denogradov; Sergey H Luzhkov; Alexei C Neofitov Journal: Biol Trace Elem Res Date: 2002 Impact factor: 3.738
Authors: G H Guyatt; M J Sullivan; P J Thompson; E L Fallen; S O Pugsley; D W Taylor; L B Berman Journal: Can Med Assoc J Date: 1985-04-15 Impact factor: 8.262
Authors: Murray J Leikis; Michael J McKenna; Aaron C Petersen; Annette B Kent; Kate T Murphy; James A Leppik; Xiaofei Gong; Lawrence P McMahon Journal: Clin J Am Soc Nephrol Date: 2006-04-19 Impact factor: 8.237
Authors: A St John; M B Thomas; C P Davies; B Mullan; I Dick; B Hutchison; A van der Schaff; R L Prince Journal: Nephron Date: 1992 Impact factor: 2.847
Authors: Monirah M Almurdhi; Neil D Reeves; Frank L Bowling; Andrew J M Boulton; Maria Jeziorska; Rayaz A Malik Journal: Diabetes Care Date: 2016-01-06 Impact factor: 19.112
Authors: Tyler Barker; Vanessa T Henriksen; Thomas B Martins; Harry R Hill; Carl R Kjeldsberg; Erik D Schneider; Brian M Dixon; Lindell K Weaver Journal: Nutrients Date: 2013-04-17 Impact factor: 5.717