Session: SUN 257-280-Disorders of Vitamin D Metabolism & Action
Poster Board SUN-265
Microalbuminuria is a risk factor for cardiovascular morbidity and mortality in patients with diabetes. Reduction in albuminuria has been found to have beneficial effects on the outcomes. However, it is not known if vitamin D can decrease albuminuria/proteinuria.
This is a incident case – control study of consecutive diabetic chronic kidney disease patients with vitamin deficiency (defined as ≤20). Urine albumin creatinine ratio was obtained for all the cases and controls. Controls also had diabetic kidney disease but without microalbuminuria. Controls were selected from the same zip codes of the cases and were matched on age, gender, race, estimated GFR and number of hypertensive medications. Urine albumin creatinine ratio was compared between both groups using ANOVA. Multivariable logistic regression analysis was used to evaluate effect of vitamin D deficiency on cardiovascular effects.
Out of 402 patients with diabetic kidney disease, 201 patients (mean age 67±13 years, 46.7% men) had urine microalbuminuria. Patients with 25 hydroxy - vitamin D deficiency had more microalbuminuria 1698±740 mg compared to 627±405 mg in patients without deficiency (p = 0.0001). There was no increased all – cause mortality however, there was increased risk of heart failure related hospitalization (OR 1.92; 95% CI 1.10 – 3.37, p = 0.022) and non fatal myocardial infarction (OR 2.46; 95% CI 1.39 – 4.35, p = 0.002) with vitamin D deficiency in diabetic renal disease patients.
In conclusion, our study shows that in diabetic renal disease, vitamin D deficiency exacerbates the microalbuminuria which may explain the cardiovascular morbidity and mortality in this group of patients.
Nothing to Disclose: LS, MH, WQ, DA, ML
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