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- Title
Mortality Rates Across 25-Hydroxyvitamin D (25[OH]D) Levels among Adults with and without Estimated Glomerular Filtration Rate < 60 ml/min/1.73 m²: The Third National Health and Nutrition Examination Survey.
- Authors
Kramer, Holly; Sempos, Chris; Cao, Guichan; Luke, Amy; Shoham, David; Cooper, Richard; Durazo-Arvizu, Ramon
- Abstract
Background:Previous studies exploring the association between 25[OH]D levels and mortality in adults with and without kidney disease utilized 25[OH]D thresholds that have recently been scrutinized by the Institute of Medicine Committee to Review Dietary References Intakes for Vitamin D and Calcium. Objective: We explored all-cause mortality rates across the spectrum of 25[OH]D levels over an eighteen-year follow-up among adults with and without an estimated glomerular filtration rate (eGFR) ,60 ml/min/1.73 m2. Design:The study included 1,097 U.S. adults with eGFR ,60 ml/min/1.73 m2 and 14, 002 adults with eGFR $60 ml/min/ 1.73 m2. Mortality rates and rate ratios (RR) across 25[OH]D groups were calculated with Poisson regression and restricted cubic splines while adjusting for covariates. Results: Prevalence of 25[OH]D levels ,30 and ,20 ng/ml among adults with eGFR ,60 ml/min/1.73 m2 was 76.5% (population estimate 6.2 million) and 35.4% (population estimate 2.9 million), respectively. Among adults with eGFR $60 ml/min/1.73 m2, 70.5% had 25[OH]D levels ,30 ng/ml (population estimate 132.2 million) while 30.3% had 25[OH]D levels ,20 ng/ml (population estimate 56.8 million). Significantly higher mortality rates were noted among individuals with 25[OH]D levels ,12 ng/ml compared to referent group (24 to ,30 ng/ml): RR1.41 (95% CI 1.17, 1.71) among individuals with eGFR ,60 ml/min/1.73 m2 and RR 1.32 (95% CI 1.13, 1.56) among individuals with eGFR ≥60 ml/min/1.73 m2 after adjustment for covariates including co-morbid conditions. Mortality rates were fairly similar across all 25[OH]D groups with levels .20 ng/ml after adjustment for all covariates. Conclusions:Regardless of presence of eGFR ,60 ml/min/1.73 m2, mortality rates across groups with 25[OH]D levels 20-40 ng/ml are similar.
- Subjects
MORTALITY; KIDNEY diseases; GLOMERULAR filtration rate; DEATH; KIDNEY function tests; KIDNEY glomerulus
- Publication
PLoS ONE, 2012, Vol 7, Issue 10, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0047458