EFFECT OF VITAMIN D SUPPLEMENTATION ON KIDNEY FUNCTION IN ADULTS WITH PREDIABETES
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Keywords
Vitamin D, Pre-diabetes, Kidney outcomes, Serum 25[OH]D levels, Glycemic parameters
Abstract
Background: In clinical research, low serum 25[OH]D levels have been linked to increased levels of proteinuria and decreased levels of eGFR.
Objective: This study examined how vitamin D supplementation affected kidney outcomes in a pre-diabetic cohort.
Method: Adults who met two of the three glycemic parameters for pre-diabetes and were overweight or obese and at high risk of developing type 2 diabetes were randomised to receive 4000 IU of vitamin D3 daily versus a placebo. The mean length of therapy was 18 months. Kidney outcomes comprised deterioration in the Kidney Disease: Improving Global Outcomes (KDIGO) risk score (low, moderate, high, or very high) on two successive follow-up visits following the baseline visit, as well as mean fluctuations in eGFR & urine albumin-to Creatinine ratio (UACR).
Results: Among 600 participants (mean age 59 years, body mass index 33.1 kg/m2, serum 25(OH)D 29.3 ng/ml, eGFR87 ml/min per 1.73 m2, UACR 11 mg/g, 79.5% with hypertension). Over a mean follow-up of 18 months, there were 20 cases of KDIGO worsening in group A and 16 in the placebo group (hazard ratio, 0.79; 95% confidence interval [95% CI], (0.42 to 1.41). The mean difference in eGFR from baseline was -1.2 ml/min per 1.73 m2 (95% CI, 1.4 to 0.8) in the group A and 0.7 ml/min per 1.73 m2 (95% CI, 0.6 to 0.3) in the placebo group.
Conclusion: Vitamin D supplementation did not significantly influence advancing KDIGO risk scores, UACR, or eGFR in people with pre-diabetes who were not chosen based on blood 25(OH)D concentration.
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Talal Safdar
Assistant Professor of Medicine, Fauji Foundation Hospital Rawalpindi, Pakistan