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Talal Safdar
Shahzad Khan Siddique
Hassan Javed
Moazama Shakeel Ahmed
Fnu Kirshma
Sidra Kausar


Vitamin D, Pre-diabetes, Kidney outcomes, Serum 25[OH]D levels, Glycemic parameters


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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1. Association, A.D., 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2020. Diabetes care, 2020. 43(Supplement_1): p. S14-S31.
2. Pittas, A.G., et al., The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism, 2007. 92(6): p. 2017-2029.
3. de Boer, I.H., et al., 25-hydroxyvitamin D levels and albuminuria in the Third National Health and Nutrition Examination Survey (NHANES III). American Journal of Kidney Diseases, 2007. 50(1): p. 69-77.
4. Damasiewicz, M.J., et al., 25-Hydroxyvitamin D levels and chronic kidney disease in the AusDiab (Australian Diabetes, Obesity and Lifestyle) study. BMC nephrology, 2012. 13(1): p. 1-8.
5. Damasiewicz, M.J., et al., Serum 25-hydroxyvitamin D deficiency and the 5-year incidence of CKD. American journal of kidney diseases, 2013. 62(1): p. 58-66.
6. Melamed, M.L., et al., 25-hydroxyvitamin D levels, race, and the progression of kidney disease. Journal of the American Society of Nephrology: JASN, 2009. 20(12): p. 2631.
7. Szymczak-Pajor, I. and A. Śliwińska, Analysis of association between vitamin D deficiency and insulin resistance. Nutrients, 2019. 11(4): p. 794.
8. Li, Y.C., et al., Vitamin D: a negative endocrine regulator of the renin–angiotensin system and blood pressure. The Journal of steroid biochemistry and molecular biology, 2004. 89: p. 387-392.
9. Zhang, Z., et al., Renoprotective role of the vitamin D receptor in diabetic nephropathy. Kidney International, 2008. 73(2): p. 163-171.
10. Jamali, N., C.M. Sorenson, and N. Sheibani, Vitamin D and regulation of vascular cell function. American Journal of Physiology-Heart and Circulatory Physiology, 2018. 314(4): p. H753-H765.
11. O’Seaghdha, C.M., et al., Phylloquinone and vitamin D status: associations with incident chronic kidney disease in the Framingham Offspring cohort. American journal of nephrology, 2012. 36(1): p. 68-77.
12. Guessous, I., et al., Serum 25-hydroxyvitamin D level and kidney function decline in a Swiss general adult population. Clinical Journal of the American Society of Nephrology: CJASN, 2015. 10(7): p. 1162.
13. De Zeeuw, D., et al., Selective vitamin D receptor activation with paricalcitol for reduction of albuminuria in patients with type 2 diabetes (VITAL study): a randomised controlled trial. The Lancet, 2010. 376(9752): p. 1543-1551.
14. Thadhani, R. et al., Vitamin D therapy and cardiac structure and function in patients with chronic kidney disease: the PRIMO randomised controlled trial. Jama, 2012. 307(7): p. 674-684.
15. de Boer, I.H., et al., Effect of vitamin D and omega-3 fatty acid supplementation on kidney function in patients with type 2 diabetes: a randomised clinical trial. Jama, 2019. 322(19): p. 1899-1909.
16. Del Valle, H.B. et al., Dietary reference intakes for calcium and vitamin D. 2011.
17. Echouffo‐Tcheugui, J., et al., Association between prediabetes and risk of chronic kidney disease: a systematic review and meta‐analysis. Diabetic Medicine, 2016. 33(12): p. 1615-1624.
18. Bigotte Vieira, M., et al., Impaired fasting glucose and chronic kidney disease, albuminuria, or worsening kidney function: a secondary analysis of SPRINT. The Journal of Clinical Endocrinology & Metabolism, 2019. 104(9): p. 4024-4032.

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