#3556 ASSOCIATION OF SERUM 25-HYDROXYVITAMIN D WITH ALL-CAUSE MORTALITY AND KIDNEY OUTCOME IN PATIENTS WITH EARLY STAGES OF CKD

Abstract

Abstract Background and Aims Although serum 25-hydroxyvitamin D (25(OH)D) deficiency is prevalent in all stages of chronic kidney disease (CKD), the effects of 25(OH)D deficiency on all-cause mortality and kidney outcomes in patients with early-stage CKD remain incompletely understood. Method This nationwide retrospective cohort study included 9840 adults with stages 1–3 CKD from 19 medical centers across China. The study outcomes included all-cause mortality, cardiovascular mortality, and kidney disease progression. The associations between serum 25(OH)D concentrations and the risks of mortality and CKD progression were evaluated using a Cox proportional hazard model. A mixed-effects model was used to estimate the slopes of estimated glomerular filtration rate (eGFR). Results Of 9840 adults with stages 1–3 CKD, 26.9% had severe (<10 ng/ml) and 38.7% had moderate (10–20 ng/ml) serum 25(OH)D deficiency. Compared with patients having 25(OH)D >20 ng/ml, patients with serum 25(OH)D <10 ng/ml were at significantly higher risks of all-cause mortality (hazard ratio [HR] 1.87, 95% confidence interval [CI] 1.53–2.28), cardiovascular mortality (HR 1.80, 95% CI 1.33–2.44), and CKD progression (HR 2.28, 95% CI 1.74–2.99), and had a steeper decline in eGFR slope (estimate -0.07; 95% CI -0.10 to -0.05 mL/min/1.73 m2 per year). Similar results were obtained in subgroups and by sensitivity analyses. Conclusion 25(OH)D deficiency is associated with increased risks of all-cause mortality and CKD progression in patients with early-stage CKD. Studies are needed to determine whether early intervention for 25(OH)D deficiency could improve the prognosis of patients with early-stage CKD.