TY - JOUR
T1 - Effect of vitamin D supplementation on kidney function in adults with prediabetes a secondary analysis of a randomized trial
AU - Kim, Sun H.
AU - Brodsky, Irwin G.
AU - Chatterjee, Ranee
AU - Kashyap, Sangeeta R.
AU - Knowler, William C.
AU - Liao, Emilia
AU - Nelson, Jason
AU - Pratley, Richard
AU - Rasouli, Neda
AU - Vickery, Ellen M.
AU - Sarnak, Mark
AU - Pittas, Anastassios G.
AU - Pittas, Anastassios G.
AU - Brodsky, Irwin
AU - Ceglia, Lisa
AU - Chadha, Chhavi
AU - Chatterjee, Ranee
AU - Dawson-Hughes, Bess
AU - Desouza, Cyrus
AU - Dolor, Rowena
AU - Foreyt, John
AU - Ghazi, Adline
AU - Hsia, Daniel S.
AU - Johnson, Karen C.
AU - Kim, Sun
AU - Leblanc, Erin S.
AU - Lewis, Michael R.
AU - Liao, Emilia
AU - Malozowski, Saul
AU - Neff, Lisa M.
AU - O'Neil, Patrick
AU - Park, Jean
AU - Peters, Anne
AU - Phillips, Lawrence S.
AU - Pratley, Richard
AU - Raskin, Philip
AU - Rasouli, Neda
AU - Robbins, David
AU - Rosen, Clifford
AU - Aroda, Vanita R.
AU - Sheehan, Patricia
AU - Staten, Myrlene A.
AU - Knowler, William C.
N1 - Publisher Copyright:
© 2021 by the American Society of Nephrology.
PY - 2021/8
Y1 - 2021/8
N2 - 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.
AB - 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.
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U2 - 10.2215/CJN.00420121
DO - 10.2215/CJN.00420121
M3 - Article
C2 - 34362787
AN - SCOPUS:85114053668
SN - 1555-9041
VL - 16
SP - 1201
EP - 1209
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 8
ER -