25 (OH) Vitamin D Levels and Renal Disease Progression in Patients with Type 2 Diabetic Nephropathy and Blockade of the Renin-Angiotensin System

Experimental studies show that 25 (OH) vitamin D is a suppressor of renin biosynthesis and that vitamin D deficiency has been associated with CKD progression. Patients with type II diabetes and CKD have an exceptionally high rate of severe 25 (OH) vitamin D deficiency; however, it is not known wheth...

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Published in:Clinical journal of the American Society of Nephrology 2013-11, Vol.8 (11), p.1870-1876
Main Authors: Fernández-Juárez, Gema, Luño, José, Barrio, Vicente, de Vinuesa, Soledad García, Praga, Manuel, Goicoechea, Marian, Lahera, Vicente, Casas, Luisa, Oliva, Jesús
Format: Article
Language:English
Subjects:
Aged
Aldosterone - blood
Angiotensin II Type 1 Receptor Blockers - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Biomarkers - blood
Chi-Square Distribution
Creatinine - blood
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - mortality
Diabetic Nephropathies - blood
Diabetic Nephropathies - diagnosis
Diabetic Nephropathies - drug therapy
Diabetic Nephropathies - etiology
Diabetic Nephropathies - mortality
Diabetic Nephropathies - physiopathology
Disease Progression
Female
Glomerular Filtration Rate - drug effects
Humans
Kaplan-Meier Estimate
Kidney - drug effects
Kidney - metabolism
Kidney - physiopathology
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - etiology
Male
Middle Aged
Multivariate Analysis
Original
Proportional Hazards Models
Renin-Angiotensin System - drug effects
Risk Factors
Spain
Time Factors
Treatment Outcome
Vitamin D - analogs & derivatives
Vitamin D - blood
Vitamin D Deficiency - blood
Vitamin D Deficiency - complications
Vitamin D Deficiency - diagnosis
Vitamin D Deficiency - mortality
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Summary:Experimental studies show that 25 (OH) vitamin D is a suppressor of renin biosynthesis and that vitamin D deficiency has been associated with CKD progression. Patients with type II diabetes and CKD have an exceptionally high rate of severe 25 (OH) vitamin D deficiency; however, it is not known whether this deficiency is a risk factor for progression of diabetic nephropathy. This study aimed to investigate whether there is an association of 25 (OH) vitamin D deficiency with disease progression in type II diabetic nephropathy. 25 (OH) vitamin D levels were measured at baseline and 4 and 12 months in 103 patients included in a multicenter randomized controlled trial to compare the efficacy of combining an angiotensin-converting enzyme inhibitor and an angiotensin receptor blocker with the efficacy of each drug in monotherapy to slow progression of established diabetic nephropathy during 2006-2011. The primary composite endpoint was a >50% increase in baseline serum creatinine, ESRD, or death. All study participants were included in the analysis. Fifty-three patients (51.5%) had 25 (OH) vitamin D deficiency (
ISSN:1555-9041
1555-905X
DOI:10.2215/CJN.00910113