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Epimeric vitamin D and cardiovascular structure and function in advanced CKD and after kidney transplantation.
Arroyo, Eliott; Leber, Cecilia A; Burney, Heather N; Li, Yang; Li, Xiaochun; Lu, Tzong-Shi; Jones, Glenville; Kaufmann, Martin; Ting, Stephen M S; Hiemstra, Thomas F; Zehnder, Daniel; Lim, Kenneth.
Afiliación
  • Arroyo E; Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Leber CA; Division of Nephrology & Hypertension, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Burney HN; Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN, USA.
  • Li Y; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Li X; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Lu TS; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Jones G; Renal Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
  • Kaufmann M; Department of Biomedical and Molecular Sciences and Medicine, Queen's University, Kingston, Ontario, Canada.
  • Ting SMS; Department of Biomedical and Molecular Sciences and Medicine, Queen's University, Kingston, Ontario, Canada.
  • Hiemstra TF; Department of Medicine, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, UK.
  • Zehnder D; Cambridge Clinical Trials Unit, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK.
  • Lim K; School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Nephrol Dial Transplant ; 39(2): 264-276, 2024 Jan 31.
Article en En | MEDLINE | ID: mdl-37468453
BACKGROUND: 25-hydroxyvitamin D can undergo C-3 epimerization to produce 3-epi-25(OH)D3. 3-epi-25(OH)D3 levels decline in chronic kidney disease (CKD), but its role in regulating the cardiovascular system is unknown. Herein, we examined the relationship between 3-epi-25(OH)D3, and cardiovascular functional and structural endpoints in patients with CKD. METHODS: We examined n = 165 patients with advanced CKD from the Cardiopulmonary Exercise Testing in Renal Failure and After Kidney Transplantation (CAPER) study cohort, including those who underwent kidney transplant (KTR, n = 76) and waitlisted patients who did not (NTWC, n = 89). All patients underwent cardiopulmonary exercise testing and echocardiography at baseline, 2 months and 12 months. Serum 3-epi-25(OH)D3 was analyzed by liquid chromatography-tandem mass spectrometry. RESULTS: Patients were stratified into quartiles of baseline 3-epi-25(OH)D3 (Q1: <0.4 ng/mL, n = 51; Q2: 0.4 ng/mL, n = 26; Q3: 0.5-0.7 ng/mL, n = 47; Q4: ≥0.8 ng/mL, n = 41). Patients in Q1 exhibited lower peak oxygen uptake [VO2Peak = 18.4 (16.2-20.8) mL/min/kg] compared with Q4 [20.8 (18.6-23.2) mL/min/kg; P = .009]. Linear mixed regression model showed that 3-epi-25(OH)D3 levels increased in KTR [from 0.47 (0.30) ng/mL to 0.90 (0.45) ng/mL] and declined in NTWC [from 0.61 (0.32) ng/mL to 0.45 (0.29) ng/mL; P < .001]. Serum 3-epi-25(OH)D3 was associated with VO2Peak longitudinally in both groups [KTR: ß (standard error) = 2.53 (0.56), P < .001; NTWC: 2.73 (0.70), P < .001], but was not with left ventricular mass or arterial stiffness. Non-epimeric 25(OH)D3, 24,25(OH)2D3 and the 25(OH)D3:24,25(OH)2D3 ratio were not associated with any cardiovascular outcome (all P > .05). CONCLUSIONS: Changes in 3-epi-25(OH)D3 levels may regulate cardiovascular functional capacity in patients with advanced CKD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema Cardiovascular / Trasplante de Riñón / Insuficiencia Renal Crónica Límite: Humans Idioma: En Revista: Nephrol Dial Transplant Asunto de la revista: NEFROLOGIA / TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema Cardiovascular / Trasplante de Riñón / Insuficiencia Renal Crónica Límite: Humans Idioma: En Revista: Nephrol Dial Transplant Asunto de la revista: NEFROLOGIA / TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido