Lee Juyeon, Bae Eun Hui, Kim Soo Wan, Chung Wookyung, Kim Yeong Hoon, Oh Yun Kyu, Kim Yong-Soo, Oh Kook-Hwan, Park Sue K
Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Department of Biomedical Science, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Front Med (Lausanne). 2023 Feb 16;10:1017459. doi: 10.3389/fmed.2023.1017459. eCollection 2023.
Some observational studies have suggested a possible association between vitamin D deficiency and CKD. However, in most studies, the causality between low levels of vitamin D and risk of renal events could not be explained. We investigated the relationship between vitamin D deficiency and risk of severe CKD stage and renal event in a large-scale prospective cohort study.
We used data from a prospective cohort of 2,144 patients with available information on serum 25-hydroxyvitamin D (25(OH)D) levels at baseline from KNOW-CKD, 2011-2015 were included. Vitamin D deficiency was defined as serum 25(OH)D levels < 15 ng/mL. We performed a cross-sectional analysis to elucidate the relationship between 25(OH)D and CKD stage using baseline CKD patient data. We further examined a cohort analysis to clarify the association between 25(OH)D and risk of renal event. Renal event was a composite of the first occurrence of a 50% decline in eGFR from the baseline value or the onset of CKD stage 5 (initiation of dialysis or kidney transplantation) across the follow-up period. We also investigated the associations of vitamin D deficiency with risk of renal event according to diabetes and overweight status.
Vitamin D deficiency were significantly associated with an increased risk of severe CKD stage - 1.30-fold (95% CI: 1.10-1.69) for 25(OH)D. Deficiency of 25(OH)D with 1.64-fold (95% CI: 1.32-2.65) was related to renal event compared with the reference. Furthermore, vitamin D deficiency patients with presence of DM and overweight status also displayed higher risk than non-deficient patients for risk of renal event.
Vitamin D deficiency is associated with significantly increased risk of severe CKD stage and renal event.
一些观察性研究表明维生素D缺乏与慢性肾脏病（CKD）之间可能存在关联。然而，在大多数研究中，维生素D水平低与肾脏事件风险之间的因果关系无法得到解释。我们在一项大规模前瞻性队列研究中调查了维生素D缺乏与严重CKD分期及肾脏事件风险之间的关系。
我们使用了来自KNOW-CKD前瞻性队列中2144例患者的数据，这些患者在2011 - 2015年基线时具有血清25-羟基维生素D（25(OH)D）水平的可用信息。维生素D缺乏定义为血清25(OH)D水平<15 ng/mL。我们使用基线CKD患者数据进行横断面分析，以阐明25(OH)D与CKD分期之间的关系。我们进一步进行队列分析，以明确25(OH)D与肾脏事件风险之间的关联。肾脏事件是指在随访期间估算肾小球滤过率（eGFR）较基线值下降50%或CKD 5期（开始透析或肾脏移植）首次发生的综合情况。我们还根据糖尿病和超重状态调查了维生素D缺乏与肾脏事件风险之间的关联。
维生素D缺乏与严重CKD分期风险增加显著相关——25(OH)D的风险比为1.30倍（95%置信区间：1.10 - 1.69）。与参照组相比，25(OH)D缺乏与肾脏事件相关，风险比为1.64倍（95%置信区间：1.32 - 2.65）。此外，患有糖尿病和超重的维生素D缺乏患者发生肾脏事件的风险也高于非缺乏患者。
维生素D缺乏与严重CKD分期和肾脏事件风险显著增加相关。
