Serum 1,25-Dihydroxyvitamin D and the Development of Kidney Dysfunction in a Japanese Community

– The Hisayama Study –

Abstract

Background: Recent evidence indicates that vitamin D deficiency is associated with an increased risk of renal impairment, but studies addressing the influence of vitamin D deficiency on the development of chronic kidney disease (CKD) in the general Asian population have been few. Methods and Results: A total of 2,417 community-dwelling individuals without CKD stage 3–5 aged ≥40 years were followed for 5 years (mean age, 60 years; women, 59.1%). The cumulative incidence of CKD stage 3–5, defined as estimated glomerular filtration rate (eGFR) <60ml·min⁻¹·1.73m⁻², and the rate of decline in eGFR according to quartile of serum 1,25-dihydroxyvitamin D (1,25(OH)₂D), were estimated. During follow-up, 378 subjects experienced CKD stage 3–5. The age- and sex-adjusted incidence of CKD stage 3–5 increased significantly with decreasing serum 1,25(OH)₂D (P for trend <0.001). Compared with the highest quartile, the multivariate-adjusted odds ratio for the development of CKD stage 3–5 was 1.90 in the lowest quartile and 1.74 in the second lowest quartile, after adjusting for confounding factors. Additionally, lower serum 1,25(OH)₂D was significantly associated with a greater change in eGFR (−0.10ml·min⁻¹·1.73m⁻²·year⁻¹ per 10-pg/ml decrement in serum 1,25(OH)₂D). Conclusions: Lower serum 1,25(OH)₂D is a significant risk factor for the development of CKD stage 3–5 in the general Asian population.  (Circ J 2014; 78: 732–737)