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Updated: Jun 14, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Vitamin D status and intermediate vascular and bone outcomes in chronic kidney disease: a secondary post hoc analysis
Wing-Chi G Yeung1,2,3, Nigel D Toussaint4,5, Nicole Lioufas4,5
1Department of Nephrology, Wollongong Hospital, Wollongong, New South Wales, Australia.
Insights
Vitamin D deficiency was not linked to arterial stiffness, aortic calcification, or bone mineral density in chronic kidney disease patients. This study found no association between 25-hydroxyvitamin D levels and these cardiovascular and bone health markers.
Area of Science:
- Nephrology
- Endocrinology
- Cardiovascular Medicine
Background:
- Cardiovascular disease (CVD) is the primary cause of mortality in chronic kidney disease (CKD) patients, linked to mineral metabolism issues and vascular calcification.
- Vitamin D plays a role in parathyroid hormone regulation, calcium and phosphate metabolism, vascular function, and bone health.
Purpose of the Study:
- To investigate the association between vitamin D deficiency and arterial stiffness, aortic calcification, and bone mineral density (BMD) in patients with CKD.
- To test the hypothesis that low vitamin D levels correlate with increased vascular calcification and reduced BMD in CKD.
Main Methods:
- A cross-sectional analysis of baseline data from the IMPROVE-CKD study cohort.
- Vitamin D deficiency was defined as 25-hydroxyvitamin D (25(OH)D) <50 nmol/L.
- Associations between serum 25(OH)D and pulse wave velocity (PWV), augmentation index (AIx), abdominal aortic calcification (Agatston score), and lumbar spine BMD were assessed using regression analyses.
Main Results:
- Of 208 participants, 27% had vitamin D deficiency (25(OH)D <50 nmol/L).
- Patients with vitamin D deficiency were more likely to have diabetes, cardiovascular disease, and lower serum calcium.
- Serum 25(OH)D levels showed no association with PWV, AIx, Agatston score, or BMD on univariable and multivariable regression analyses.
Conclusions:
- Baseline 25-hydroxyvitamin D levels were not associated with key markers of vascular function or bone mineral density in patients with CKD stages 3b and 4.
- The findings do not support a direct link between vitamin D status and these intermediate vascular and bone health indicators in this CKD population.
Background And Aims:
Cardiovascular disease is the leading cause of death in patients with chronic kidney disease (CKD) and has been associated with abnormalities of mineral metabolism and vascular calcification. Vitamin D influences parathyroid hormone values and calcium and phosphate metabolism, and may play a role in vascular function and bone health. We aimed to test our hypothesis that vitamin D deficiency is associated with arterial stiffness, aortic calcification and lower bone mineral density (BMD) in patients with CKD.
Methods:
A cross-sectional analysis was performed using baseline data from the IMpact of Phosphate Reduction On Vascular Endpoints in CKD (IMPROVE-CKD) study cohort. Clinical and laboratory parameters were compared between those with and without vitamin D deficiency, defined as 25-hydroxyvitamin D (25(OH)D) <50 nmol/L. Univariable and multivariable linear regression analyses were performed to assess associations between serum 25(OH)D levels and pulse wave velocity (PWV), augmentation index (AIx), abdominal aortic calcification (measured by the Agatston score) and lumbar spine BMD.
Results:
Baseline 25(OHD) values were available in 208 out of 278 IMPROVE-CKD study participants, with a mean value of 70.1 ± 30.7 nmol/L. Of these, 57 (27%) patients had vitamin D deficiency. Those with 25(OH)D deficiency were more likely to have diabetes (56% vs 38%), cardiovascular disease (54% vs 36%) and lower serum calcium (2.29 ± 0.13 vs 2.34 ± 0.13 mmol/L). On univariable and multivariable regression analyses, baseline 25(OH)D values were not associated with PWV, the AIx, Agatston score or BMD.
Conclusion:
Baseline 25(OH)D levels were not associated with intermediate markers of vascular function and BMD in patients with CKD stages 3b and 4.
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