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Vitamin D deficiency may predict a poorer outcome of IgA nephropathy
BACKGROUND: Experimental studies showed that 25-hydroxy-vitamin D [25(OH)D] deficiency (defined as 25-hydroxy-vitamin D < 15 ng/ml) has been associated with CKD progression. Patients with IgA nephropathy have an exceptionally high rate of severe 25(OH)D deficiency; however, it is not known whethe...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094030/ https://www.ncbi.nlm.nih.gov/pubmed/27806690 http://dx.doi.org/10.1186/s12882-016-0378-4 |
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author | Li, Xiao-Hua Huang, Xin-Ping Pan, Ling Wang, Cheng-Yu Qin, Ju Nong, Feng-Wei Luo, Yu-Zhen Wu, Yue Huang, Yu-Ming Peng, Xi Yang, Zhen-Hua Liao, Yun-Hua |
author_facet | Li, Xiao-Hua Huang, Xin-Ping Pan, Ling Wang, Cheng-Yu Qin, Ju Nong, Feng-Wei Luo, Yu-Zhen Wu, Yue Huang, Yu-Ming Peng, Xi Yang, Zhen-Hua Liao, Yun-Hua |
author_sort | Li, Xiao-Hua |
collection | PubMed |
description | BACKGROUND: Experimental studies showed that 25-hydroxy-vitamin D [25(OH)D] deficiency (defined as 25-hydroxy-vitamin D < 15 ng/ml) has been associated with CKD progression. Patients with IgA nephropathy have an exceptionally high rate of severe 25(OH)D deficiency; however, it is not known whether this deficiency is a risk factor for progression of IgA nephropathy. We conducted this study to investigate the relationship between the plasma level of 25(OH)D and certain clinical parameters and renal histologic lesions in the patients with IgA nephropathy, and to evaluate whether the 25(OH)D level could be a good prognostic marker for IgA nephropathy progression. METHODS: A total of 105 patients with biopsy-proven IgA nephropathy were enrolled between 2012 and 2015. The circulating concentration of 25(OH)D was determined using serum samples collected at the time of biopsy. The primary clinical endpoint was the decline of estimated glomerular filtration rate (eGFR; a 30 % or more decline compared to the baseline). RESULTS: Mean eGFR decreased and proteinuria worsened proportionally as circulating 25(OH)D decreased (P < 0.05). The 25(OH)D deficiency was correlated with a higher tubulointerstitial score by the Oxford classification (P = 0.008). The risk for reaching the primary endpoint was significantly higher in the patients with a 25(OH)D deficiency compared to those with a higher level of 25(OH)D (P = 0.001). As evaluated using the Cox proportional hazards model, 25(OH)D deficiency was found to be an independent risk factor for renal progression [HR 5.99, 95 % confidence intervals (CIs) 1.59–22.54, P = 0.008]. CONCLUSION: A 25(OH)D deficiency at baseline is significantly correlated with poorer clinical outcomes and more sever renal pathological features, and low levels of 25(OH)D at baseline were strongly associated with increased risk of renal progression in IgAN. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-016-0378-4) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5094030 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-50940302016-11-07 Vitamin D deficiency may predict a poorer outcome of IgA nephropathy Li, Xiao-Hua Huang, Xin-Ping Pan, Ling Wang, Cheng-Yu Qin, Ju Nong, Feng-Wei Luo, Yu-Zhen Wu, Yue Huang, Yu-Ming Peng, Xi Yang, Zhen-Hua Liao, Yun-Hua BMC Nephrol Research Article BACKGROUND: Experimental studies showed that 25-hydroxy-vitamin D [25(OH)D] deficiency (defined as 25-hydroxy-vitamin D < 15 ng/ml) has been associated with CKD progression. Patients with IgA nephropathy have an exceptionally high rate of severe 25(OH)D deficiency; however, it is not known whether this deficiency is a risk factor for progression of IgA nephropathy. We conducted this study to investigate the relationship between the plasma level of 25(OH)D and certain clinical parameters and renal histologic lesions in the patients with IgA nephropathy, and to evaluate whether the 25(OH)D level could be a good prognostic marker for IgA nephropathy progression. METHODS: A total of 105 patients with biopsy-proven IgA nephropathy were enrolled between 2012 and 2015. The circulating concentration of 25(OH)D was determined using serum samples collected at the time of biopsy. The primary clinical endpoint was the decline of estimated glomerular filtration rate (eGFR; a 30 % or more decline compared to the baseline). RESULTS: Mean eGFR decreased and proteinuria worsened proportionally as circulating 25(OH)D decreased (P < 0.05). The 25(OH)D deficiency was correlated with a higher tubulointerstitial score by the Oxford classification (P = 0.008). The risk for reaching the primary endpoint was significantly higher in the patients with a 25(OH)D deficiency compared to those with a higher level of 25(OH)D (P = 0.001). As evaluated using the Cox proportional hazards model, 25(OH)D deficiency was found to be an independent risk factor for renal progression [HR 5.99, 95 % confidence intervals (CIs) 1.59–22.54, P = 0.008]. CONCLUSION: A 25(OH)D deficiency at baseline is significantly correlated with poorer clinical outcomes and more sever renal pathological features, and low levels of 25(OH)D at baseline were strongly associated with increased risk of renal progression in IgAN. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-016-0378-4) contains supplementary material, which is available to authorized users. BioMed Central 2016-11-02 /pmc/articles/PMC5094030/ /pubmed/27806690 http://dx.doi.org/10.1186/s12882-016-0378-4 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Li, Xiao-Hua Huang, Xin-Ping Pan, Ling Wang, Cheng-Yu Qin, Ju Nong, Feng-Wei Luo, Yu-Zhen Wu, Yue Huang, Yu-Ming Peng, Xi Yang, Zhen-Hua Liao, Yun-Hua Vitamin D deficiency may predict a poorer outcome of IgA nephropathy |
title | Vitamin D deficiency may predict a poorer outcome of IgA nephropathy |
title_full | Vitamin D deficiency may predict a poorer outcome of IgA nephropathy |
title_fullStr | Vitamin D deficiency may predict a poorer outcome of IgA nephropathy |
title_full_unstemmed | Vitamin D deficiency may predict a poorer outcome of IgA nephropathy |
title_short | Vitamin D deficiency may predict a poorer outcome of IgA nephropathy |
title_sort | vitamin d deficiency may predict a poorer outcome of iga nephropathy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094030/ https://www.ncbi.nlm.nih.gov/pubmed/27806690 http://dx.doi.org/10.1186/s12882-016-0378-4 |
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