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Vitamin D deficiency and endothelial dysfunction in non-dialysis chronic kidney disease patients.
MedLine Citation:
PMID:  22071357     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Cardiovascular (CV) events are common in patients with chronic kidney disease (CKD) but inadequately explained by traditional risk factors. Vitamin D deficiency is highly prevalent in CKD and has been proposed to be a non-traditional risk factor, but its relationship with vascular function is unknown. METHODS AND RESULTS: The aim of this study was to investigate the relationship between vitamin D levels and endothelial function in non-diabetes patients with mild to moderate CKD. Endothelial function was measured non-invasively using brachial artery flow mediated dilation (FMD). 25 hydroxy vitamin D levels were measured using electrochemiluminescence immunoassay. In 50 CKD patients (age 56±11 years, BMI 25±4kg/m(2), 46% females, 14% smokers, 86% hypertensives, 52% with dyslipidaemia) the mean vitamin D level was 53±33nmol/L (21±13ng/L). The mean FMD was 3.8±2.4%. Decreasing 25 hydroxy vitamin D levels were associated with decreasing FMD [r=0.44, p=0.001]. In multivariate analysis the association remained independent after adjustment with traditional risk factors (adjusted beta 0.451; t=3.46; p<0.002). Patients with low vitamin D (≤37.5nmol/L) demonstrated low FMD compared to patients with vitamin D values >37.5nmol/L (4.4±2.5% vs. 2.5±1.6%; p=0.007); however the traditional risk factors were similar between the two groups. CONCLUSION: This is the first demonstration of an association of vitamin D deficiency with abnormal vascular endothelial function in non-dialysis CKD patients. Further studies with intervention and exploration of the mechanism are needed to establish a cause effect relationship.
Authors:
Nihil Chitalia; Alejandro Recio-Mayoral; Juan Carlos Kaski; Debasish Banerjee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-25
Journal Detail:
Title:  Atherosclerosis     Volume:  -     ISSN:  1879-1484     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-11-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ireland Ltd.
Affiliation:
Renal and Transplantation Unit, St Georges Healthcare NHS Trust and Cardiovascular Sciences Research Centre, St Georges, University of London, Blackshaw Road, Tooting, London SW17 0QT, UK.
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