25-Hydroxyvitamin D Levels, Race, and the Progression of Kidney Disease Export

@article{citeulike:6045433, abstract = {Black individuals have lower 25-hydroxyvitamin D [25(OH)D] levels and experience a disproportionate burden of ESRD compared with white individuals. Animal studies suggest that vitamin D has renoprotective effects. We evaluated the contribution of low 25(OH)D levels on incidence of ESRD using data from the Third National Health and Nutrition Examination Survey-linked Medicare claims files (n = 13,328). We included baseline (1988 through 1994) measurements of 25(OH)D and assessed the incidence of ESRD through July 31, 2001. Overall, 34\% of non-Hispanic black individuals had 25(OH)D levels <15 ng/ml compared with 5\% of non-Hispanic white individuals (P < 0.001). During a median of 9.1 yr, 65 participants developed ESRD. After adjustment for demographic, socioeconomic, and clinical and laboratory factors (including diabetes, hypertension, estimated GFR, and albuminuria), participants with 25(OH)D levels <15 ng/ml had a 2.6-fold greater incidence of ESRD than those with levels [\&ge;]15 ng/ml (incidence rate ratio 2.64; 95\% confidence interval [CI] 1.00 to 7.05; P = 0.05). After adjustment for clinical covariates but not 25(OH)D levels, non-Hispanic black individuals had a 2.83-fold (95\% CI 1.03 to 7.77) higher risk for developing ESRD compared with non-Hispanic white individuals. Additional adjustment for 25(OH)D levels reduced the risk by 58\% (incidence rate ratio 1.77; 95\% CI 0.38 to 8.21). In summary, low 25(OH)D levels associate with development of ESRD even after adjustment for multiple risk factors. Low 25(OH)D levels may account for a substantial proportion of the increased risk for ESRD experienced by black individuals. 10.1681/ASN.2009030283}, author = {Melamed, Michal L. and Astor, Brad and Michos, Erin D. and Hostetter, Thomas H. and Powe, Neil R. and Muntner, Paul}, citeulike-article-id = {6045433}, citeulike-linkout-0 = {http://dx.doi.org/10.1681/ASN.2009030283}, citeulike-linkout-1 = {http://jasn.asnjournals.org/content/ASN.2009030283v1/.abstract}, citeulike-linkout-2 = {http://jasn.asnjournals.org/content/ASN.2009030283v1/.full.pdf}, citeulike-linkout-3 = {http://view.ncbi.nlm.nih.gov/pubmed/19875805}, citeulike-linkout-4 = {http://www.hubmed.org/display.cgi?uids=19875805}, day = {29}, doi = {10.1681/ASN.2009030283}, issn = {1533-3450}, journal = {J Am Soc Nephrol}, keywords = {renal, risk, vitamind-system}, month = {October}, pages = {ASN.2009030283+}, posted-at = {2009-10-30 23:35:09}, priority = {2}, title = {25-Hydroxyvitamin D Levels, Race, and the Progression of Kidney Disease}, url = {http://dx.doi.org/10.1681/ASN.2009030283}, year = {2009} }

TY - JOUR ID - citeulike:6045433 L3 - citeulike-article-id:6045433 N2 - Black individuals have lower 25-hydroxyvitamin D [25(OH)D] levels and experience a disproportionate burden of ESRD compared with white individuals. Animal studies suggest that vitamin D has renoprotective effects. We evaluated the contribution of low 25(OH)D levels on incidence of ESRD using data from the Third National Health and Nutrition Examination Survey-linked Medicare claims files (n = 13,328). We included baseline (1988 through 1994) measurements of 25(OH)D and assessed the incidence of ESRD through July 31, 2001. Overall, 34% of non-Hispanic black individuals had 25(OH)D levels <15 ng/ml compared with 5% of non-Hispanic white individuals (P < 0.001). During a median of 9.1 yr, 65 participants developed ESRD. After adjustment for demographic, socioeconomic, and clinical and laboratory factors (including diabetes, hypertension, estimated GFR, and albuminuria), participants with 25(OH)D levels <15 ng/ml had a 2.6-fold greater incidence of ESRD than those with levels [&ge;]15 ng/ml (incidence rate ratio 2.64; 95% confidence interval [CI] 1.00 to 7.05; P = 0.05). After adjustment for clinical covariates but not 25(OH)D levels, non-Hispanic black individuals had a 2.83-fold (95% CI 1.03 to 7.77) higher risk for developing ESRD compared with non-Hispanic white individuals. Additional adjustment for 25(OH)D levels reduced the risk by 58% (incidence rate ratio 1.77; 95% CI 0.38 to 8.21). In summary, low 25(OH)D levels associate with development of ESRD even after adjustment for multiple risk factors. Low 25(OH)D levels may account for a substantial proportion of the increased risk for ESRD experienced by black individuals. 10.1681/ASN.2009030283 JF - J Am Soc Nephrol SN - 1533-3450 TI - 25-Hydroxyvitamin D Levels, Race, and the Progression of Kidney Disease SP - ASN.2009030283 KW - renal KW - risk KW - vitamind-system AU - Melamed, Michal AU - Astor, Brad AU - Michos, Erin AU - Hostetter, Thomas AU - Powe, Neil AU - Muntner, Paul PY - 2009/10/29/ UR - http://dx.doi.org/10.1681/ASN.2009030283 ER -