Vitamin D deficiency may predict a poorer outcome of IgA nephropathyReportar como inadecuado




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BMC Nephrology

, 17:164

Clinical Research

Abstract

BackgroundExperimental studies showed that 25-hydroxy-vitamin D 25OHD deficiency defined as 25-hydroxy-vitamin D < 15 ng-ml has been associated with CKD progression. Patients with IgA nephropathy have an exceptionally high rate of severe 25OHD deficiency; however, it is not known whether this deficiency is a risk factor for progression of IgA nephropathy. We conducted this study to investigate the relationship between the plasma level of 25OHD and certain clinical parameters and renal histologic lesions in the patients with IgA nephropathy, and to evaluate whether the 25OHD level could be a good prognostic marker for IgA nephropathy progression.

MethodsA total of 105 patients with biopsy-proven IgA nephropathy were enrolled between 2012 and 2015. The circulating concentration of 25OHD was determined using serum samples collected at the time of biopsy. The primary clinical endpoint was the decline of estimated glomerular filtration rate eGFR; a 30 % or more decline compared to the baseline.

ResultsMean eGFR decreased and proteinuria worsened proportionally as circulating 25OHD decreased P < 0.05. The 25OHD deficiency was correlated with a higher tubulointerstitial score by the Oxford classification P = 0.008. The risk for reaching the primary endpoint was significantly higher in the patients with a 25OHD deficiency compared to those with a higher level of 25OHD P = 0.001. As evaluated using the Cox proportional hazards model, 25OHD deficiency was found to be an independent risk factor for renal progression HR 5.99, 95 % confidence intervals CIs 1.59–22.54, P = 0.008.

ConclusionA 25OHD deficiency at baseline is significantly correlated with poorer clinical outcomes and more sever renal pathological features, and low levels of 25OHD at baseline were strongly associated with increased risk of renal progression in IgAN.

KeywordsDisease progression IgA nephropathy Prognosis Risk factor Vitamin D Abbreviations25OHD25-hydroxy-vitamin D

ACEIAngiotensin converting enzyme inhibitor

ANOVAOne-way analysis of variance

ARBAngiotensin II receptor blockade

BMIBody mass index

CIsConfidence intervals

CKDChronic kidney diseases

CKD-EPIChronic kidney disease epidemiology collaboration

eGFREstimated glomerular filtration rate

ESRDEnd-stage renal diseases

IgANIgA nephropathy

ISImmunosuppressors

RASRenin-angiotensin system

Electronic supplementary materialThe online version of this article doi:10.1186-s12882-016-0378-4 contains supplementary material, which is available to authorized users.

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Autor: Xiao-Hua Li - Xin-Ping Huang - Ling Pan - Cheng-Yu Wang - Ju Qin - Feng-Wei Nong - Yu-Zhen Luo - Yue Wu - Yu-Ming Huang -

Fuente: https://link.springer.com/



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