dc.contributor.author |
Shroff R |
|
dc.contributor.author |
Aitkenhead H |
|
dc.contributor.author |
Costa N |
|
dc.contributor.author |
Trivelli A |
|
dc.contributor.author |
Litwin M |
|
dc.contributor.author |
Picca S |
|
dc.contributor.author |
Anarat A |
|
dc.contributor.author |
Sallay, Péter |
|
dc.contributor.author |
Ozaltin F |
|
dc.contributor.author |
Zurowska A |
|
dc.contributor.author |
Jankauskiene A |
|
dc.contributor.author |
Montini G |
|
dc.contributor.author |
Charbit M |
|
dc.contributor.author |
Schaefer F |
|
dc.contributor.author |
Wuhl E |
|
dc.contributor.author |
ESCAPE Trial Group |
|
dc.date.accessioned |
2016-11-02T16:21:50Z |
|
dc.date.available |
2016-11-02T16:21:50Z |
|
dc.date.issued |
2016 |
|
dc.identifier.citation |
pagination=314-322;
journalVolume=27;
journalIssueNumber=1;
journalTitle=JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY; |
|
dc.identifier.uri |
http://repo.lib.semmelweis.hu//handle/123456789/3007 |
|
dc.identifier.uri |
doi:10.1681/ASN.2014090947 |
|
dc.description.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-hydroxyvitamin D (25(OH)D), FGF-23, and Klotho levels were measured at baseline and after a median 8 months on ACEi. Children with 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 diastolic BP (P=0.004). ACEi therapy also associated with increased Klotho levels (P<0.001). The annualized loss of eGFR was inversely associated with baseline 25(OH)D level (P<0.001, r=0.32). Five-year renal survival was 75% in patients with baseline 25(OH)D >/=50 nmol/L and 50% in those with lower 25(OH)D levels (P<0.001). This renoprotective effect remained significant but attenuated with ACEi therapy (P=0.05). Renal survival increased 8.2% per 10 nmol/L increase in 25(OH)D (P=0.03), independent of eGFR; proteinuria, BP, and FGF-23 levels; and underlying renal diagnosis. In children with CKD, 25(OH)D >/=50 nmol/L was associated with greater preservation of renal function. This effect was present but attenuated with concomitant ACEi therapy. |
|
dc.relation.ispartof |
urn:issn:1046-6673 |
|
dc.title |
Normal 25-Hydroxyvitamin D Levels Are Associated with Less Proteinuria and Attenuate Renal Failure Progression in Children with CKD |
|
dc.type |
Journal Article |
|
dc.date.updated |
2016-01-07T08:32:01Z |
|
dc.language.rfc3066 |
en |
|
dc.identifier.mtmt |
2932104 |
|
dc.identifier.pubmed |
26069294 |
|
dc.contributor.department |
SE/AOK/K/I. Sz. Gyermekgyógyászati Klinika |
|
dc.contributor.institution |
Semmelweis Egyetem |
|
dc.mtmt.swordnote |
CN ESCAPE Trial Group |
|