What is the optimal level of vitamin D in non-dialysis chronic kidney disease population?
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Título: | What is the optimal level of vitamin D in non-dialysis chronic kidney disease population? |
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Autor/es: | Molina, Pablo | Górriz, José L. | Molina Vila, Mariola D. | Beltrán, Sandra | Vizcaíno, Belén | Escudero, Verónica | Kanter, Julia | Ávila, Ana I. | Bover, Jordi | Fernández, Elvira | Nieto, Javier | Cigarrán, Secundino | Gruss, Enrique | Fernández-Juárez, Gema | Martínez-Castelao, Alberto | Navarro-González, Juan F. | Romero, Ramón | Pallardó, Luis M. |
Grupo/s de investigación o GITE: | Laboratorio de Optimización (LOPT) |
Centro, Departamento o Servicio: | Universidad de Alicante. Departamento de Matemáticas |
Palabras clave: | Vitamin D | Chronic kidney disease | Mortality | Renal progression | Hospitalization |
Área/s de conocimiento: | Estadística e Investigación Operativa |
Fecha de publicación: | 6-sep-2016 |
Editor: | Baishideng Publishing Group |
Cita bibliográfica: | World Journal of Nephrology. 2016, 5(5): 471-481. doi:10.5527/wjn.v5.i5.471 |
Resumen: | AIM: To evaluate thresholds for serum 25(OH)D concentrations in relation to death, kidney progression and hospitalization in non-dialysis chronic kidney disease (CKD) population. METHODS: Four hundred and seventy non-dialysis 3-5 stage CKD patients participating in OSERCE-2 study, a prospective, multicenter, cohort study, were prospectively evaluated and categorized into 3 groups according to 25(OH)D levels at enrollment (less than 20 ng/mL, between 20 and 29 ng/mL, and at or above 30 ng/mL), considering 25(OH)D between 20 and 29 ng/mL as reference group. Association between 25(OH)D levels and death (primary outcome), and time to first hospitalization and renal progression (secondary outcomes) over a 3-year follow-up, were assessed by Kaplan-Meier survival curves and Cox-proportional hazard models. To identify 25(OH)D levels at highest risk for outcomes, receiver operating characteristic (ROC) curves were performed. RESULTS: Over 29 ± 12 mo of follow-up, 46 (10%) patients dead, 156 (33%) showed kidney progression, and 126 (27%) were hospitalized. After multivariate adjustment, 25(OH)D < 20 ng/mL was an independent predictor of all-cause mortality (HR = 2.33; 95%CI: 1.10-4.91; P = 0.027) and kidney progression (HR = 2.46; 95%CI: 1.63-3.71; P < 0.001), whereas the group with 25(OH)D at or above 30 ng/mL did not have a different hazard for outcomes from the reference group. Hospitalization outcomes were predicted by 25(OH) levels (HR = 0.98; 95%CI: 0.96-1.00; P = 0.027) in the unadjusted Cox proportional hazards model, but not after multivariate adjusting. ROC curves identified 25(OH)D levels at highest risk for death, kidney progression, and hospitalization, at 17.4 ng/mL [area under the curve (AUC) = 0.60; 95%CI: 0.52-0.69; P = 0.027], 18.6 ng/mL (AUC = 0.65; 95%CI: 0.60-0.71; P < 0.001), and 19.0 ng/mL (AUC = 0.56; 95%CI: 0.50-0.62; P = 0.048), respectively. CONCLUSION: 25(OH)D < 20 ng/mL was an independent predictor of death and progression in patients with stage 3-5 CKD, with no additional benefits when patients reached the levels at or above 30 ng/mL suggested as optimal by CKD guidelines. |
Patrocinador/es: | Abbott and the Spanish Society of Nephrology |
URI: | http://hdl.handle.net/10045/61641 |
ISSN: | 2220-6124 |
DOI: | 10.5527/wjn.v5.i5.471 |
Idioma: | eng |
Tipo: | info:eu-repo/semantics/article |
Derechos: | © The author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. Articles published by this open-access journal are distributed under the terms of the Creative Commons Attribution-Noncommercial (CC BY-NC 4.0) License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. |
Revisión científica: | si |
Versión del editor: | http://dx.doi.org/10.5527/wjn.v5.i5.471 |
Aparece en las colecciones: | INV - LOPT - Artículos de Revistas INV - AppBiochem - Artículos de Revistas INV - GESTA - Artículos de Revistas |
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