Article Figures & Data
Figures
- Figure 1.
Scatter plot showing an inverse relationship between coronary artery calcification score and bone mineral density in non–dialysis-dependent patients with chronic kidney disease (Spearman correlation coefficient −0.26, P = 0.002).
Tables
- Table 1.
Demographic, clinical, dietary, and laboratory characteristics of adults enrolled in the NHANES III, based on the presence and stage of CKDa
Characteristic Non-CKD CKD P Stage 1 Stage 2 Stage 3 Stage 4 or 5 Prevalence (%) 86.2 6.2 3.5 3.8 0.2 Age (yr) 41.1 ± 0.4 43.7 ± 0.8 59.5 ± 0.9 70.2 ± 0.8 70.7 ± 1.8 <0.0001 Male gender (%) 48.4 44.6 53.0 38.7 39.6 0.0070 Race/ethnicity (%) white 76.0 64.8 80.9 86.8 66.7 black 10.6 17.5 10.7 7.5 23.1 <0.0001 Mexican American 5.5 7.3 3.0 1.4 2.8 other 7.9 10.4 5.4 4.3 7.4 Serum creatinine (mg/dl) 1.0 ± 0.0 1.0 ± 0.0 1.2 ± 0.0 1.5 ± 0.0 4.0 ± 0.4 <0.0001 eGFR (ml/min per 1.73 m2) 103.7 ± 0.6 115.2 ± 1.0 76.8 ± 0.4 50.8 ± 0.3 21.1 ± 1.3 <0.0001 Vitamin D levels (ng/ml; %) >30 45.9 33.4 39.5 36.5 17.0 15 to 30 45.7 52.5 51.4 52.8 55.8 <0.0001 <15 8.4 14.1 9.1 10.7 27.2 Taking vitamin D supplements (%) 27.9 23.2 25.6 27.1 17.1 0.0800 Total vitamin D intake (diet + supplements; IU/d) 309.1 ± 7.3 282.0 ± 13.4 324.5 ± 22.3 319.6 ± 19.2 288.7 ± 57.9 0.3000 Current smokers (%) 29.2 32.6 23.2 13.7 19.6 <0.0001 Hypertension (%) 17.6 33.3 59.3 72.7 74.4 <0.0001 BMI (kg/m2) 26.3 ± 0.1 27.2 ± 0.3 28.2 ± 0.5 27.7 ± 0.2 26.7 ± 1.1 <0.0001 Diabetes (%) 4.6 18.6 28.3 21.7 29.8 <0.0001 Non-HDL cholesterol ≥160 (mg/dl, % 38.7 42.9 57.4 68.4 50.2 <0.0001 Serum CRP (mg/dl; %) undetectable 74.1 60.6 58.7 50.8 35.1 0.30 to 0.99 19.8 24.1 27.0 30.8 37.4 <0.0001 ≥1 6.1 15.2 14.3 18.4 27.4 Serum albumin (g/dl) 4.2 ± 0.0 4.2 ± 0.0 4.1 ± 0.0 4.0 ± 0.0 3.8 ± 0.1 <0.0001 Corrected serum calcium (mg/dl) 9.2 ± 0.0 9.3 ± 0.0 9.4 ± 0.1 9.5 ± 0.0 9.4 ± 0.1 <0.0001 Serum phosphorus (mg/dl) 3.5 ± 0.0 3.4 ± 0.0 3.4 ± 0.0 3.5 ± 0.0 4.1 ± 0.1 <0.0001 No medical insurance (%) 13.6 14.7 7.6 2.5 0.1 <0.0001 Education <12 yr (%) 19.7 27.9 32.8 43.8 49.4 <0.0001 Income <200% of federal poverty level (%) 32.6 42.0 36.8 45.9 55.1 <0.0001 ↵a BMI, body mass index; CKD, chronic kidney disease; CRP, C-reactive protein; eGFR, estimated GFR; NHANES III, Third National Health and Nutrition Examination Survey.
- Table 2.
Adjusted odds for 25OHD insufficiency (15 to 30 ng/ml) and deficiency (<15 ng/ml) among the participants of the NHANES III with CKDa
Parameter CKD (OR [95% CI]) Analysis 1b 25OHD 15 to 30 ng/ml 1.13 (0.92 to 1.39) 25OHD <15 ng/ml 1.32 (1.03 to 1.72) Analysis 2c 25OHD 15 to 30 ng/ml 1.15 (0.92 to 1.44) 25OHD <15 ng/ml 1.39 (1.09 to 1.77) ↵a 25OHD, 25-hydroxyvitamin D.
↵b Adjusted for age, gender, race/ethnicity, BMI, vitamin D intake (diet and supplements), medical insurance, educational level, family income, and month of the year (n = 12,620).
↵c Adjusted for age, gender, race/ethnicity, BMI, vitamin D intake (diet and supplements), medical insurance, educational level, family income, month of the year, current smoking, hypertension, diabetes, non-HDL cholesterol, serum CRP, and serum albumin (n = 12,475).
Characteristic Overall Deficiency (<15 ng/ml) Insufficiency (15 to 30 ng/ml) Optimal (>30 ng/ml) P n 146 55 66 25 Age (yr) 57.0 ± 0.6 54.0 ± 0.9 57.5 ± 0.8 62.5 ± 1.8 <0.001 Male gender (%) 51 40 59 52 0.110 Race/ethnicity (%) Latino 77 66 82 88 0.002 black 10 24 3 0 white 13 11 15 12 Serum creatinine (mg/dl)b 1.3 (1.0, 1.8) 1.6 (1.1, 2.1) 1.3 (1.0, 1.8) 1.0 (0.8, 1.5) 0.003 eGFR (ml/min per 1.73 m2) 55.4 ± 2.1 47.9 ± 23.8 57.3 ± 2.9 66.8 ± 5.1 0.004 Urine albumin-to-creatinine ratio (mg/mg)b 1.99 (0.79, 3.93) 3.02 (0.85, 4.31) 2.05 (0.97, 3.77) 0.91 (0.58, 2.21) 0.020 Diabetes duration (yr) 15.3 ± 0.5 16.7 ± 0.9 14.3 ± 0.7 15.2 ± 1.2 0.110 Current smokers (%) 13 9 15 16 0.550 Hypertension (%) 95 96 91 100 0.180 Dyslipidemia (%) 84 82 86 84 0.790 BMI (kg/m2) 31.2 ± 0.6 32.7 ± 1.0 30.7 ± 1.0 29.2 ± 1.1 0.110 Serum CRPb 0.4 (0.1, 0.8) 0.5 (0.1, 0.9) 0.4 (0.1, 0.9) 0.2 (0.1, 0.5) 0.200 HbA1c (%) 8.6 ± 0.2 8.3 ± 0.4 8.7 ± 0.3 9.1 ± 0.4 0.350 Serum albumin (g/dl) 3.2 ± 0.1 3.1 ± 0.1 3.3 ± 0.1 3.5 ± 0.1 0.002 Corrected serum calcium (mg/dl) 9.8 ± 0.0 9.7 ± 0.1 9.8 ± 0.1 9.8 ± 0.1 0.630 Serum phosphorus (mg/dl) 4.3 ± 0.1 4.4 ± 0.1 4.3 ± 0.1 4.2 ± 0.1 0.310 Serum PTH (pg/ml)b 51 (32, 79) 61 (40, 112) 45 (31, 67) 40 (22, 55) <0.001 BMD (mg/cm3) 130.2 ± 4.3 143.4 ± 6.2 127.0 ± 7.0 108.3 ± 8.3 0.020 Prevalence of T score <−1.0 (%) 64 56 66 79 Coronary artery calcification Prevalence (score >10) (%) 75 58 83 88 0.002 scoreb 149 (9, 488) 85 (0, 325) 200 (25, 637) 196 (59, 370) 0.040 - Table 4.
Characteristics of patients who had diabetic nephropathy and underwent follow-up evaluationa
Characteristic Overall Deficiency (<15 ng/ml) Insufficiency (15 to 30 ng/ml) Optimal (>30 ng/ml) P Number 72 24 33 15 Age (yr) 57.5 ± 0.9 53.8 ± 1.3 57.5 ± 1.2 63.3 ± 2.0 <0.001 Male gender (%) 43 29 49 53 0.230 Race/ethnicity (%) Latino 89 96 82 93 0.210 white 11 4 18 7 Diabetes duration (yr) 15.4 ± 0.7 16.0 ± 1.2 14.2 ± 1.0 16.8 ± 1.7 0.310 Current smokers (%) 10 4 18 0 0.080 Hypertension (%) 94 96 91 100 0.420 Dyslipidemia (%) 88 88 94 73 0.140 Baseline BMI (kg/m2) 31.1 ± 0.9 33.6 ± 1.7 30.7 ± 1.4 27.7 ± 1.4 0.060 Baseline serum CRPa 0.4 (0.1, 0.6) 0.4 (0.2, 0.5) 0.5 (0.1, 0.7) 0.2 (0.1, 0.6) 0.280 Baseline HbA1c (%) 8.9 ± 0.3 8.5 ± 0.5 8.9 ± 0.4 9.7 ± 0.7 0.320 Baseline serum albumin (g/dl) 3.2 ± 0.1 2.8 ± 0.1 3.3 ± 0.1 3.5 ± 0.1 <0.001 Baseline serum creatinine (mg/dl)a 1.3 (1.0, 1.7) 1.5 (1.1, 1.8) 1.3 (1.0, 1.8) 1.0 (0.8, 1.3) 0.090 eGFR (ml/min per 1.73 m2) baseline 53 (37, 75) 44 (35, 64) 52 (37, 74) 75 (47, 80) 0.060 follow-up 44 (27, 58) 33 (16, 53) 39 (27, 58) 59 (43, 80) 0.010 change −11 (−21, −4) −16 (−27, −4) −12 (−16, −5) −8 (−14, −2) 0.560 Urine albumin-to-creatinine ratio (mg/mg)a baseline 2.1 (1.0, 4.1) 4.1 (1.8, 5.1) 2.0 (1.1, 3.7) 1.4 (0.6, 2.5) 0.006 follow-up 2.3 (0.7, 4.8) 3.7 (1.9, 6.9) 1.6 (0.6, 4.1) 0.9 (0.5, 3.2) 0.008 Corrected serum calcium (mg/dl) baseline 9.8 ± 0.0 9.7 ± 0.1 9.8 ± 0.1 9.8 ± 0.1 0.950 follow-up 9.7 ± 0.1 9.7 ± 0.1 9.6 ± 0.1 9.8 ± 0.1 0.140 Serum phosphorus (mg/dl) baseline 4.3 ± 0.1 4.3 ± 0.1 4.4 ± 0.1 4.3 ± 0.1 0.510 follow-up 4.4 ± 0.1 4.5 ± 0.3 4.4 ± 0.1 4.2 ± 0.2 0.670 Serum PTH (pg/ml)a baseline 53 (35, 87) 70 (46, 109) 45 (34, 67) 47 (32, 71) 0.060 follow-up 61 (36, 96) 71 (51, 112) 49 (28, 91) 52 (28, 72) 0.040 Serum 25OHD levels (ng/ml) baseline 20.9 ± 1.2 9.7 ± 0.6 22.6 ± 0.7 35.5 ± 1.0 <0.001 follow-up 19.3 ± 1.1 12.2 ± 1.2 20.3 ± 1.4 28.3 ± 3.5 <0.001 change −1.7 ± 1.1 2.5 ± 1.4 −2.3 ± 1.4 −7.1 ± 3.6 0.008 Vitamin D category on follow-up (n [%]) deficient 26 (36) 17 (71) 7 (21) 2 (13) <0.001 insufficient 34 (47) 6 (25) 22 (67) 6 (40) optimal 12 (17) 1 (4) 4 (12) 7 (47) ↵a Median {25th, 75th percentiles).
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Hypovitaminosis D in Chronic Kidney Disease
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- Association between vitamin D deficiency and exercise capacity in patients with CKD, a cross-sectional analysis
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- Cardiorespiratory Fitness Is Independently Associated with 25-Hydroxyvitamin D in Chronic Kidney Disease
- Vitamin D Supplementation in Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Observational Studies and Randomized Controlled Trials
- Prevalence and Prognostic Significance of Renal Artery Calcification in Patients with Diabetes and Proteinuria
- A Randomized Trial of Cholecalciferol versus Doxercalciferol for Lowering Parathyroid Hormone in Chronic Kidney Disease
- Treatment of Secondary Hyperparathyroidism in CKD Patients with Cinacalcet and/or Vitamin D Derivatives