Normal 25-Hydroxyvitamin D Levels Are Associated with Less Proteinuria and Attenuate Renal Failure Progression in Children with CKD

Rukshana Shroff, Helen Aitkenhead, Nikola Costa, Antonella Trivelli, Mieczyslaw Litwin, Stefano Picca, Ali Anarat, Peter Sallay, Fatih Ozaltin, Aleksandra Zurowska, Augustina Jankauskiene, Giovanni Montini, Marina Charbit, Franz Schaefer, Elke Wühl, A. Anarat, A. Bakkaloglu, F. Ozaltin, A. Peco-Antic, U. QuerfeldJ. Gellermann, P. Sallay, D. Drozdz, K. E. Bonzel, A. M. Wingen, A. Zurowska, I. Balasz, F. Perfumo, D. E. Müller-Wiefel, K. Möller, G. Offner, B. Enke, E. Wühl, C. Gimpel, O. Mehls, F. Schaefer, S. Emre, S. Caliskan, S. Mir, S. Wygoda, K. Hohbach-Hohenfellner, N. Jeck, G. Klaus, G. Ardissino, S. Testa, G. Montini, M. Charbit, P. Niaudet, A. Caldas-Afonso, A. Fernandes-Teixeira, J. Duek, M. C. Matteucci, S. Picca, A. Mastrostefano, M. Wigger, U. B. Berg, G. Celsi, M. Fischbach, J. Terzic, J. Fydryk, T. Urasinski, R. Coppo, Licia Peruzzi, K. Arbeiter, A. Jankauskiené, R. Grenda, M. Litwin, R. Janas, G. Laube, T. J. Neuhaus

Research output: Contribution to journalArticlepeer-review

Abstract

Angiotensin-converting enzyme inhibitors (ACEi) for renin-angiotensin-aldosterone system (RAAS) blockade are routinely used to slow CKD progression. However, Vitamin D may also promote renoprotection by suppressing renin transcription through cross-talk between RAAS and Vitamin D -fibroblast growth factor-23 (FGF-23)-Klotho pathways. To determine whether Vitamin D levels influence proteinuria and CKD progression in children, we performed a post hoc analysis of the Effect of Strict Blood Pressure Control and ACE Inhibition on Progression of CKD in Pediatric Patients (ESCAPE) cohort. In 167 children (median EGFR 51 ml/min per 1.73 m2), serum 25-hydroxyvitaminD(25(OH)D),FGF-23, andKlotho levelsweremeasuredatbaselineandafteramedian8months onACEi.Childrenwith lower 25(OH)D levels had higher urinary protein/creatinine ratios at baseline (P=0.03) and at follow-up (P=0.006). Levels of 25(OH)D and serum Vitamin D -binding protein were not associated, but 25(OH)D #50 nmol/L associated with higher diastolicBP(P=0.004).ACEi therapy alsoassociatedwith increasedKlotho levels (P

Original languageEnglish
Pages (from-to)314-322
Number of pages9
JournalJournal of the American Society of Nephrology
Volume27
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

ASJC Scopus subject areas

  • Nephrology

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