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4X more Chronic Kidney disease patients are now using vitamin D – March 2014

Kidney Disease Patient Use of Vitamin D Supplements Rising Renal and Urology News

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CRIC is a multicenter prospective observational cohort study that includes 3,939 participants with a mean age of 60 years and estimated glomerular filtration rate (eGFR) of 42.1 mL/min/1.73 m2. The cohort was 54.9% male and 42.1% black, and 48.4% were diabetic.

The proportion of participants reporting vitamin D supplement use increased from 10% at baseline to 44% at 7-year follow-up visits, according to Laura H. Mariani, MD, of the University of Michigan Medical School in Ann Arbor, and colleagues. Supplement use was greater among older, female, non-black, married participants with higher education and lower body mass index, the researchers noted.


Increasing use of vitamin D supplementation in the chronic renal insufficiency cohort study.

J Ren Nutr. 2014 May;24(3):186-93. doi: 10.1053/j.jrn.2014.01.015. Epub 2014 Mar 7.
Mariani LH1, White MT2, Shults J3, Anderson CA4, Feldman HI5, Wolf M6, Reese PP5, Denburg MR7, Townsend RR8, Lo JC9, Cappola AR8, Carlow D7, Gadegbeku CA10, Steigerwalt S11, Leonard MB12; CRIC Study Investigators.

OBJECTIVE:
This study examined rates and determinants of vitamin D supplementation among Chronic Renal Insufficiency Cohort (CRIC) participants and determined the association between dose and 25-hydroxyvitamin D (25(OH)D) level. The 2010 Institute of Medicine Report noted a significant increase in vitamin D supplementation in the general population, but use in chronic kidney disease (CKD) is unknown.

METHODS:
CRIC is a multicenter prospective observational cohort study of 3,939 participants with a median baseline age of 60 and an estimated glomerular filtration rate (eGFR) of 42.1 mL/minute per 1.73 m2. Of the cohort, 54.9% was male, 42.1% were Black, and 48.4% were diabetic. Multivariable logistic generalized estimating equations were used to examine determinants of supplementation use assessed annually between 2003 and 2011. Cross-sectional linear regression models, based on a subset of 1,155 participants, assessed associations between supplement dose and 25(OH)D level, measured by high-performance liquid chromatography coupled with tandem mass spectrometry.

RESULTS:
The proportion of participants reporting supplement use increased (P < .0001), from 10% at baseline to 44% at 7-year follow-up visits. This was largely due to initiation of products containing only ergocalciferol or cholecalciferol. The odds of supplementation were greater in older, female, non-Black, married participants with greater education and lower body mass index. Among participants taking supplementation, dose was positively associated with 25(OH)D level, adjusted for race, season, diabetes, dietary intake, eGFR, and proteinuria. Only 3.8% of non-Black and 16.5% of Black participants taking a supplement were deficient (<20 ng/mL), whereas 22.7% of non-Black and 62.4% of black participants not reporting supplement use were deficient.

CONCLUSIONS:
Vitamin D supplementation rates rose significantly among CRIC participants over 7 years of follow-up and were associated with greater serum 25(OH)D levels. Studies of vitamin D levels on clinical outcomes in CKD and future vitamin D interventional studies should consider these changes in supplementation practices.

Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

PMID: 24613295


See also VitaminDWiki

  • FACT: Kidney is the primary way to activate vitamin D
  • FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
  • FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
  • FACT: There are many on-going intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
  • FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
  • FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
  • Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
      Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
    Calcitriol - which bypasses the need for the kidney to activate vitamin D
      Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
        Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012
  • Category Kidney and Vitamin D contains 177 items

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