Insuficiência e deficiência de vitamina D em pacientes portadores de doença renal crônica

Diniz, Herculano Ferreira; Romão, Mariana Fadil; Elias, Rosilene Motta; Júnior, Joäo Egídio Romäo

doi:10.1590/s0101-28002012000100009

Cited by 18 publications

(7 citation statements)

References 30 publications

(48 reference statements)

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“…For example, Ravani et al found that the baseline level of 25(OH)D was directly and significantly correlated with eGFR [8]. Diniz et al also revealed an inverse correlation between the 25(OH)D level and proteinuria [30]. Furthermore, an inverse relationship between blood pressure and the 25(OH)D level has been documented as well in a number of epidemiological studies [31, 32].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency may predict a poorer outcome of IgA nephropathy

Huang

Pan

et al. 2016

BMC Nephrol

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BackgroundExperimental studies showed that 25-hydroxy-vitamin D [25(OH)D] deficiency (defined as 25-hydroxy-vitamin D < 15 ng/ml) has been associated with CKD progression. Patients with IgA nephropathy have an exceptionally high rate of severe 25(OH)D deficiency; however, it is not known whether this deficiency is a risk factor for progression of IgA nephropathy. We conducted this study to investigate the relationship between the plasma level of 25(OH)D and certain clinical parameters and renal histologic lesions in the patients with IgA nephropathy, and to evaluate whether the 25(OH)D level could be a good prognostic marker for IgA nephropathy progression.MethodsA total of 105 patients with biopsy-proven IgA nephropathy were enrolled between 2012 and 2015. The circulating concentration of 25(OH)D was determined using serum samples collected at the time of biopsy. The primary clinical endpoint was the decline of estimated glomerular filtration rate (eGFR; a 30 % or more decline compared to the baseline).ResultsMean eGFR decreased and proteinuria worsened proportionally as circulating 25(OH)D decreased (P < 0.05). The 25(OH)D deficiency was correlated with a higher tubulointerstitial score by the Oxford classification (P = 0.008). The risk for reaching the primary endpoint was significantly higher in the patients with a 25(OH)D deficiency compared to those with a higher level of 25(OH)D (P = 0.001). As evaluated using the Cox proportional hazards model, 25(OH)D deficiency was found to be an independent risk factor for renal progression [HR 5.99, 95 % confidence intervals (CIs) 1.59–22.54, P = 0.008].ConclusionA 25(OH)D deficiency at baseline is significantly correlated with poorer clinical outcomes and more sever renal pathological features, and low levels of 25(OH)D at baseline were strongly associated with increased risk of renal progression in IgAN.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0378-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency may predict a poorer outcome of IgA nephropathy

Huang

Pan

et al. 2016

BMC Nephrol

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“…Bone disorders, mineral abnormalities and vascular calcification in individuals with moderate to advanced CKD seem to be related to a progressive deficiency of active vitamin D and worsening secondary hyperparathyroidism. Serum levels of 25-hydroxyvitamin D are also inversely associated with serum PTH level both in patients with CKD [1] and in those without this disease [2]. Serum 25-hydroxyvitamin D is also an inverse predictor of disease progression and death in patients with CKD [3,4].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D insufficiency and deficiency with stages of chronic kidney disease in an Asian population

et al. 2013

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BackgroundVitamin D insufficiency is associated with proteinuria and could be a risk factor for end-stage renal disease (ESRD). However, few studies have examined the significance of vitamin D insufficiency as a contributing factor for the development of ESRD in the Asian chronic kidney disease (CKD) population.MethodsAuthors examined the relationship between vitamin D status and the staging of CKD using data from an outpatient clinic-based screening in 2,895 Thai CKD patients. Serum levels of 25-hydroxyvitamin D were analyzed according to CKD stages. Vitamin D deficiency and insufficiency were defined as a serum 25-hydroxyvitamin D concentration < 10 ng/mL and 10–30 ng/mL, respectively.ResultsThe mean (SD) 25-hydroxyvitamin D levels were significantly lower according to severity of renal impairment (CKD stage 3a: 27.84±14.03 ng/mL, CKD stage 3b: 25.86±11.14 ng/mL, CKD stage 4: 24.09±11.65 and CKD stage 5: 20.82±9.86 ng/mL, p<0.001). The prevalence of vitamin D deficiency/insufficiency was from CKD stage 3a, 3b, 4 to 5, 66.6%, 70.9%, 74.6%, and 84.7% (p<0.001). The odds ratio (95% CI) of vitamin D insufficiency/deficiency (serum 25-hydroxyvitamin D ≤ 30 ng/mL) and vitamin D deficiency (serum 25-hydroxyvitamin D < 10 ng/mL) for developing ESRD, after adjustment for age, gender, hemoglobin, serum albumin, calcium, phosphate and alkaline phosphatase were 2.19 (95% CI 1.07 to 4.48) and 16.76 (95% CI 4.89 to 57.49), respectively.ConclusionThis study demonstrates that 25-hydroxyvitamin D insufficiency and deficiency are more common and associated with the level of kidney function in the Thai CKD population especially advanced stage of CKD.

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“…Although epidemiologic data on the prevalence of vitamin D deficiency or insufficiency in patients with chronic kidney disease (CKD) are little and sparse, they has been reported to show relatively low levels of 25(OH)D because of low levels of vitamin D-binding protein, little sunlight exposure, malnutrition, dietary restriction, and inadequate ultraviolet B-mediated synthesis of vitamin D in skin [6][7][8]. In patients with early CKD, dialysis and kidney transplantation, the prevalence of vitamin D insufficiency and deficiency has been reported to be high, and it is also reported that vitamin D deficiency is more common and severe in dialysis patients than in those with early CKD [8].…”

Section: Introductionmentioning

confidence: 99%

Optimal Vitamin D levels in Children with Chronic Kidney Disease

Lee¹

2015

J Nephrol Ther

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Insuficiência e deficiência de vitamina D em pacientes portadores de doença renal crônica

Cited by 18 publications

References 30 publications

Vitamin D deficiency may predict a poorer outcome of IgA nephropathy

Vitamin D deficiency may predict a poorer outcome of IgA nephropathy

Vitamin D insufficiency and deficiency with stages of chronic kidney disease in an Asian population

Optimal Vitamin D levels in Children with Chronic Kidney Disease

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