Association of serum 25-hydroxyvitamin D with cardiovascular mortality and kidney outcome in patients with early...

Area of Science:

• Nephrology
• Endocrinology
• Cardiovascular Medicine

Background:

• Serum 25-hydroxyvitamin D (25[OH]D) deficiency is frequently observed in patients with chronic kidney disease (CKD).
• The impact of 25[OH]D deficiency on cardiovascular mortality and kidney outcomes in early-stage CKD is not fully understood.

Purpose of the Study:

• To investigate the association between serum 25(OH)D levels and cardiovascular mortality in patients with early-stage CKD (stages 1-3).
• To evaluate the effect of 25(OH)D deficiency on CKD progression, including estimated glomerular filtration rate (eGFR) decline and progression to end-stage kidney disease.

Main Methods:

• A multicenter retrospective cohort study involving 9229 adult patients with stages 1-3 CKD across 19 medical centers in China.
• Data were collected between January 2000 and May 2021.
• Primary outcome: cardiovascular mortality. Secondary outcomes: CKD progression and annual eGFR change.

Main Results:

• 27.0% of patients had severe ( < 10 ng/mL) and 38.9% had moderate (10 to < 20 ng/mL) 25(OH)D deficiency.
• Severe 25(OH)D deficiency (< 10 ng/mL) was associated with significantly higher risks of cardiovascular mortality (HR 1.90) and CKD progression (HR 2.20) compared to levels ≥ 20 ng/mL.
• Patients with severe deficiency also experienced a steeper annual decline in eGFR (-7.87% per year).

Conclusions:

• Serum 25(OH)D deficiency is linked to increased cardiovascular mortality and CKD progression in patients with early-stage CKD.
• Further research is required to determine if early intervention for 25(OH)D deficiency can improve outcomes for these patients.