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Vitamin D deficiency, CD4+CD28null cells and accelerated atherosclerosis in chronic kidney disease

Ashok Kumar Yadav1, Debasish Banerjee, Anupam Lal

  • 1Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Nephrology (Carlton, Vic.)
|April 12, 2012
PubMed

Insights

Vitamin D deficiency is linked to atherosclerosis in chronic kidney disease (CKD) patients. Lower vitamin D levels correlate with inflammation and abnormal T cells, contributing to cardiovascular disease risk in CKD.

Area of Science:

  • Nephrology
  • Cardiology
  • Immunology

Background:

  • Cardiovascular disease (CVD) is a primary cause of mortality in chronic kidney disease (CKD) patients.
  • The specific role of vitamin D in CVD development within the CKD population remains unclear.
  • Investigating the interplay between vitamin D, immune cells, inflammation, and atherosclerosis is crucial for CKD management.

Purpose of the Study:

  • To evaluate the relationship between 25-hydroxyvitamin D levels, T helper cell subsets (CD4+CD28null), systemic inflammation (hsCRP), and atherosclerosis (CCA-IMT) in CKD patients.
  • To determine if vitamin D deficiency is associated with preclinical atherosclerotic changes in individuals with stage 4-5 non-dialysis CKD.
  • To explore potential links between vitamin D metabolism, T cell modulation, and atherosclerosis development in CKD.

Main Methods:

  • A cross-sectional study involving 101 stage 4-5 non-dialysis CKD patients and 40 healthy controls.
  • Measurement of common carotid artery intima media thickness (CCA-IMT) via ultrasound.
  • Quantification of serum 25(OH) vitamin D, hsCRP, and circulating CD4+CD28null T cells using ELISA and flow cytometry.

Main Results:

  • CKD patients exhibited significantly higher CCA-IMT, hsCRP levels, and CD4+CD28null cell frequency compared to controls.
  • CKD subjects had markedly lower 25(OH) vitamin D levels.
  • Serum 25(OH) vitamin D showed a strong inverse correlation with CCA-IMT and correlated with CD4+CD28null cell frequency and hsCRP in CKD patients. Multiple regression analysis identified 25(OH) vitamin D, diabetes, and CD4+CD28null cell frequency as independent predictors of IMT.

Conclusions:

  • Vitamin D deficiency, heightened systemic inflammation, and an increased frequency of CD4+CD28null T lymphocytes are associated with preclinical atherosclerosis in the CKD population.
  • These findings suggest a potential link between impaired vitamin D metabolism and aberrant T cell function, both contributing to atherosclerosis in CKD.
  • Targeting vitamin D supplementation and immune modulation may offer therapeutic strategies to mitigate cardiovascular risk in CKD patients.
Abstract

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