Idris Guessous1, William McClellan2, David Kleinbaum2, Viola Vaccarino2, Henry Hugues3, Olivier Boulat3, Pedro Marques-Vidal4, Fred Paccaud5, Jean-Marc Theler6, Jean-Michel Gaspoz6, Michel Burnier7, Gérard Waeber8, Peter Vollenweider8, Murielle Bochud5. 1. Division of Chronic Diseases, Institute of Social and Preventive Medicine, Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland; and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia Idris.Guessous@chuv.ch. 2. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia. 3. Service of Biomedicine. 4. Division of Chronic Diseases, Institute of Social and Preventive Medicine, Department of Internal Medicine, University Hospital Center, Lausanne, Switzerland; 5. Division of Chronic Diseases, Institute of Social and Preventive Medicine. 6. Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland; and. 7. Service of Nephrology, and. 8. Department of Internal Medicine, University Hospital Center, Lausanne, Switzerland;
Abstract
BACKGROUND AND OBJECTIVES: Molecular evidence suggests that levels of vitamin D are associated with kidney function loss. Still, population-based studies are limited and few have considered the potential confounding effect of baseline kidney function. This study evaluated the association of serum 25-hydroxyvitamin D with change in eGFR, rapid eGFR decline, and incidence of CKD and albuminuria. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Baseline (2003-2006) and 5.5-year follow-up data from a Swiss adult general population were used to evaluate the association of serum 25-hydroxyvitamin D with change in eGFR, rapid eGFR decline (annual loss >3 ml/min per 1.73 m(2)), and incidence of CKD and albuminuria. Serum 25-hydroxyvitamin D was measured at baseline using liquid chromatography-tandem mass spectrometry. eGFR and albuminuria were collected at baseline and follow-up. Multivariate linear and logistic regression models were used considering potential confounding factors. RESULTS: Among the 4280 people included in the analysis, the mean±SD annual eGFR change was -0.57±1.78 ml/min per 1.73 m(2), and 287 (6.7%) participants presented rapid eGFR decline. Before adjustment for baseline eGFR, baseline 25-hydroxyvitamin D level was associated with both mean annual eGFR change and risk of rapid eGFR decline, independently of baseline albuminuria. Once adjusted for baseline eGFR, associations were no longer significant. For every 10 ng/ml higher baseline 25-hydroxyvitamin D, the adjusted mean annual eGFR change was -0.005 ml/min per 1.73 m(2) (95% confidence interval, -0.063 to 0.053; P=0.87) and the risk of rapid eGFR decline was null (odds ratio, 0.93; 95% confidence interval, 0.79 to 1.08; P=0.33). Baseline 25-hydroxyvitamin D level was not associated with incidence of CKD or albuminuria. CONCLUSIONS: The association of 25-hydroxyvitamin D with eGFR decline is confounded by baseline eGFR. Sufficient 25-hydroxyvitamin D levels do not seem to protect from eGFR decline independently from baseline eGFR.
BACKGROUND AND OBJECTIVES: Molecular evidence suggests that levels of vitamin D are associated with kidney function loss. Still, population-based studies are limited and few have considered the potential confounding effect of baseline kidney function. This study evaluated the association of serum 25-hydroxyvitamin D with change in eGFR, rapid eGFR decline, and incidence of CKD and albuminuria. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Baseline (2003-2006) and 5.5-year follow-up data from a Swiss adult general population were used to evaluate the association of serum 25-hydroxyvitamin D with change in eGFR, rapid eGFR decline (annual loss >3 ml/min per 1.73 m(2)), and incidence of CKD and albuminuria. Serum 25-hydroxyvitamin D was measured at baseline using liquid chromatography-tandem mass spectrometry. eGFR and albuminuria were collected at baseline and follow-up. Multivariate linear and logistic regression models were used considering potential confounding factors. RESULTS: Among the 4280 people included in the analysis, the mean±SD annual eGFR change was -0.57±1.78 ml/min per 1.73 m(2), and 287 (6.7%) participants presented rapid eGFR decline. Before adjustment for baseline eGFR, baseline 25-hydroxyvitamin D level was associated with both mean annual eGFR change and risk of rapid eGFR decline, independently of baseline albuminuria. Once adjusted for baseline eGFR, associations were no longer significant. For every 10 ng/ml higher baseline 25-hydroxyvitamin D, the adjusted mean annual eGFR change was -0.005 ml/min per 1.73 m(2) (95% confidence interval, -0.063 to 0.053; P=0.87) and the risk of rapid eGFR decline was null (odds ratio, 0.93; 95% confidence interval, 0.79 to 1.08; P=0.33). Baseline 25-hydroxyvitamin D level was not associated with incidence of CKD or albuminuria. CONCLUSIONS: The association of 25-hydroxyvitamin D with eGFR decline is confounded by baseline eGFR. Sufficient 25-hydroxyvitamin D levels do not seem to protect from eGFR decline independently from baseline eGFR.
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Authors: Alexander Teumer; Giovanni Gambaro; Tanguy Corre; Murielle Bochud; Peter Vollenweider; Idris Guessous; Marcus E Kleber; Graciela E Delgado; Stefan Pilz; Winfried März; Catriona L K Barnes; Peter K Joshi; James F Wilson; Martin H de Borst; Gerjan Navis; Pim van der Harst; Hiddo J L Heerspink; Georg Homuth; Karlhans Endlich; Matthias Nauck; Anna Köttgen; Cristian Pattaro; Pietro Manuel Ferraro Journal: Nephrol Dial Transplant Date: 2018-12-01 Impact factor: 7.186
Authors: Sun H Kim; Irwin G Brodsky; Ranee Chatterjee; Sangeeta R Kashyap; William C Knowler; Emilia Liao; Jason Nelson; Richard Pratley; Neda Rasouli; Ellen M Vickery; Mark Sarnak; Anastassios G Pittas Journal: Clin J Am Soc Nephrol Date: 2021-08 Impact factor: 10.614