Dysregulated mineral metabolism in patients with acute kidney injury and risk of adverse outcomes.
Clin Endocrinol (Oxf)
; 79(4): 491-8, 2013 Oct.
Article
in En
| MEDLINE
| ID: mdl-23414198
ABSTRACT
OBJECTIVE:
Numerous studies have evaluated the prevalence and importance of vitamin D deficiency among patients with chronic kidney disease and end-stage renal disease; however, little is known about vitamin D levels in acute kidney injury (AKI). We evaluated the association between vitamin D metabolites and clinical outcomes among patients with AKI.DESIGN:
Prospective cohort study. PATIENTS A total of 30 participants with AKI and 30 controls from general hospital wards and intensive care units at a tertiary care hospital were recruited for the study. MEASUREMENTS Plasma levels of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)2 D], 24R,25-dihydroxyvitamin D3 , vitamin D binding protein (VDBP) and fibroblast growth factor 23 (FGF23) were measured within 24 hours of AKI onset and 5 days later. Bioavailable 25(OH)D and 1,25(OH)2 D levels, defined as the sum of free- and albumin-bound 25(OH)D and 1,25(OH)2 D, were estimated using equations.RESULTS:
Compared to controls, participants with AKI had lower levels of 1,25(OH)2 D [17 (10-22) vs 25 (15-35) pg/ml, P = 0·01], lower levels of VDBP [23 (15-31) vs 29 (25-36) mg/dl, P = 0·003] and similar levels of bioavailable 25(OH)D and 1,25(OH)2 D at enrolment. Levels of bioavailable 25(OH)D were inversely associated with severity of sepsis in the overall sample (P < 0·001). Among participants with AKI, bioavailable 25(OH)D, but not other vitamin D metabolites, was significantly associated with mortality after adjusting for age and serum creatinine (adjusted odds ratio per 1 SD ln [bioavailable 25(OH)D] = 0·16, 95% confidence interval = 0·03-0·85).CONCLUSIONS:
Bioavailable 25(OH)D could have a role as a biomarker or mediator of adverse outcomes among patients with established AKI.
Full text:
1
Database:
MEDLINE
Main subject:
Vitamin D
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Vitamin D-Binding Protein
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24,25-Dihydroxyvitamin D 3
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Acute Kidney Injury
/
Fibroblast Growth Factors
Type of study:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Female
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Humans
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Male
/
Middle aged
Language:
En
Year:
2013
Type:
Article