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摘要
Background: Experimental studies showed that 25-hydroxy-vitamin D [25(OH) D] deficiency (defined as 25-hydroxyvitamin D < 15 ng/ml) has been associated with CKD progression. Patients with IgA nephropathy have an exceptionally high rate of severe 25(OH) D deficiency; however, it is not known whether this deficiency is a risk factor for progression of IgA nephropathy. We conducted this study to investigate the relationship between the plasma level of 25(OH) D and certain clinical parameters and renal histologic lesions in the patients with IgA nephropathy, and to evaluate whether the 25(OH) D level could be a good prognostic marker for IgA nephropathy progression. @@@ Methods: A total of 105 patients with biopsy-proven IgA nephropathy were enrolled between 2012 and 2015. The circulating concentration of 25(OH) D was determined using serum samples collected at the time of biopsy. The primary clinical endpoint was the decline of estimated glomerular filtration rate (eGFR; a 30 % or more decline compared to the baseline). @@@ Results: Mean eGFR decreased and proteinuria worsened proportionally as circulating 25(OH) D decreased (P < 0.05). The 25(OH) D deficiency was correlated with a higher tubulointerstitial score by the Oxford classification (P = 0.008). The risk for reaching the primary endpoint was significantly higher in the patients with a 25(OH) D deficiency compared to those with a higher level of 25(OH) D (P = 0.001). As evaluated using the Cox proportional hazards model, 25(OH) D deficiency was found to be an independent risk factor for renal progression [HR 5.99, 95 % confidence intervals (Cls) 1. 59-22.54, P = 0.008]. @@@ Conclusion: A 25(OH) D deficiency at baseline is significantly correlated with poorer clinical outcomes and more sever renal pathological features, and low levels of 25(OH) D at baseline were strongly associated with increased risk of renal progression in IgAN.
- 出版日期2016-11-2
- 单位广西医科大学
