Effect of Vitamin D Supplementation on Kidney Function in Adults with Prediabetes: A Secondary Analysis of a Randomized Trial. Issue 8 (August 2021)

• Record Type: Journal Article
• Authors: Kim, Sun H.; Brodsky, Irwin G.; Chatterjee, Ranee; Kashyap, Sangeeta R.; Knowler, William C.; Liao, Emilia; Nelson, Jason; Pratley, Richard; Rasouli, Neda; Vickery, Ellen M.; Sarnak, Mark; Pittas, Anastassios G.
• Other Names: author non-byline.; Pittas Anastassios G. author non-byline.; Brodsky Irwin author non-byline.; Ceglia Lisa author non-byline.; Chadha Chhavi author non-byline.; Chatterjee Ranee author non-byline.; Dawson-Hughes Bess author non-byline.; Desouza Cyrus author non-byline.; Dolor Rowena author non-byline.; Foreyt John author non-byline.; Ghazi Adline author non-byline.; Hsia Daniel S. author non-byline.; Johnson Karen C. author non-byline.; Kashyap Sangeeta R. author non-byline.; Kim Sun author non-byline.; LeBlanc Erin S. author non-byline.; Lewis Michael R. author non-byline.; Liao Emilia author non-byline.; Malozowski Saul author non-byline.; Neff Lisa M. author non-byline.; O'Neil Patrick author non-byline.; Park Jean author non-byline.; Peters Anne author non-byline.; Phillips Lawrence S. author non-byline.; Pratley Richard author non-byline.; Raskin Philip author non-byline.; Rasouli Neda author non-byline.; Robbins David author non-byline.; Rosen Clifford author non-byline.; Aroda Vanita R. author non-byline.; Sheehan Patricia author non-byline.; Staten Myrlene A. author non-byline.; Knowler William C. author non-byline.;
• Is Part Of: Clinical journal of the American Society of Nephrology. Volume 16:Issue 8(2021)
• Page Start: 1201
• Page End: 1209
• Publication Date: 2021-08
• Subjects: vitamin D -- glomerular filtration rate -- albuminuria -- diabetes mellitus -- microalbuminuria -- proteinuria
• DOI: 10.2215/CJN.00420121
• Languages: English
• ISSNs: 1555-9041

Abstract

Visual Abstract: Abstract : 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 Vitamin D and Type 2 Diabetes (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: Improving Global Outcomes (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-to-creatinine ratio (UACR). Results: Among 2166 participants (mean age 60 years, body mass index 32 kg/m 2, serum 25(OH)D 28 ng/ml, eGFR 87 ml/min per 1.73 m 2, 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 vitamin D group 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 was −1.0 ml/min per 1.73 m 2 (95% CI, −1.3 to −0.7) in the vitamin D group and −0.1 ml/min per 1.73 m 2 (95% CI, −0.4 to 0.2) in the placebo group; between-group difference was −1.0 ml/min per 1.73 m 2 (95% CI, −1.4 to −0.6). Mean difference in UACR was 2.7 mg/g (95% CI, 1.2 to 4.3) in the vitamin D group and 2.0 (95% CI, 0.5 to 3.6) in the placebo group; between-group difference was 0.7 mg/g (95% CI, −1.5 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.