Background and objectives Low serum 25-hydroxyvitamin D (25[OH]D) concentration has been associated with higher levels of proteinuria and lower levels of eGFR in observational studies. In the VitaminDand Type 2Diabetes (D2d) study, we investigated the effect of vitamin D supplementation on kidney outcomes in a population with prediabetes. Design, setting, participants, & measurements Overweight/obese adults with high risk for type 2 diabetes (defined by meeting two of three glycemic criteria for prediabetes) were randomized to vitamin D3 4000 IU per day versus placebo.Median duration of treatment was 2.9 years (interquartile range 2.0–3.5 years). Kidney outcomes included (1)worsening in Kidney Disease: ImprovingGlobalOutcomes (KDIGO) risk score (low,moderate, high, very high) on two consecutive follow-up visits after the baseline visit and (2) mean changes in eGFR and urine albumin-tocreatinine ratio (UACR). ResultsAmong2166 participants (mean age 60 years, body mass index 32kg/m2, serum 25(OH)D 28 ng/ml,eGFR 87 ml/min per 1.73 m2, UACR 11 mg/g, 79% with hypertension), 10% had moderate, high, or very high KDIGO risk score. Over a median follow-up of 2.9 years, there were 28 cases of KDIGO worsening in the vitaminDgroup and 30 in the placebo group (hazard ratio, 0.89; 95% confidence interval [95% CI], 0.52 to 1.52]). Mean difference in eGFR from baseline was21.0 ml/min per 1.73m2 (95% CI,21.3 to20.7) in the vitaminDgroup and20.1 ml/min per 1.73 m2 (95% CI, 20.4 to 0.2) in the placebo group; between-group difference was 21.0 ml/min per 1.73 m2 (95% CI,21.4 to20.6). Mean difference inUACR was 2.7 mg/g (95% CI, 1.2 to 4.3) in the vitaminDgroup and 2.0 (95% CI, 0.5 to 3.6) in the placebo group; between-group difference was 0.7 mg/g (95% CI, 21.5 to 2.9). Conclusions Among persons with prediabetes, who were not preselected on the basis of serum 25(OH)D concentration, vitamin D supplementation did not affect progression of KDIGO risk scores and did not have a meaningful effect on change in UACR or eGFR.
|Original language||English (US)|
|Number of pages||9|
|Journal||Clinical Journal of the American Society of Nephrology|
|State||Published - Aug 2021|
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine