25-Hydroxyvitamin D deficiency and inflammation and their association with hemoglobin levels in chronic kidney disease.
OBJECTIVE
There is limited information about the association of anemia with 25-hydroxyvitamin D [25(OH)D] deficiency and inflammation in the setting of decreased kidney function in the general population.


METHODS
We examined the association that anemia has with 25(OH)D deficiency and inflammation among 16,301 participants in the Third National Health and Nutrition Examination Survey (NHANES III). Measures of kidney function were estimated glomerular filtration rate (GFR) by using the Modification of Diet in Renal Disease equation.


RESULTS
The age-adjusted prevalence of anemia (hemoglobin <12 g/dl) at an estimated GFR of 59-30 ml/min/1.73 m(2) was 17% increasing to 56% for those participants with an estimated GFR <30 ml/min/1.73 m(2), while the age-adjusted prevalence of elevated C-reactive protein (CRP >0.21 mg/dl) and reduced 25(OH)D (<20 ng/ml) was 50 and 30%, respectively. After adjusting for demographics, comorbidities and laboratory results, 25(OH)D <20 ng/ml (OR: 1.17; 95% CI: 1.03-1.32; p = 0.014) and log CRP (OR: 3.63; 95% CI: 2.4-5.48 per unit increase of log CRP; p < 0.0001) were associated with hemoglobin levels <12 g/dl.


CONCLUSIONS
This study provides evidence that lower 25(OH)D and higher CRP levels are independently associated with lower hemoglobin concentrations in kidney disease subjects not requiring dialysis.
Kendrick
Jessica
J
Division of Renal Diseases and Hypertension, University of Colorado Denver Health Sciences Center, Denver, Colo. 80262, USA.
Targher
Giovanni
G
Smits
Gerard
G
Chonchol
Michel
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000096:biosynthesis; D005260:Female; D005919:Glomerular Filtration Rate; D006454:Hemoglobins / Q000737:chemistry* / Q000378:metabolism; D006801:Humans; D007249:Inflammation; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D014481:United States; D014807:Vitamin D / Q000031:analogs & derivatives / Q000096:biosynthesis; D014808:Vitamin D Deficiency / Q000097:blood* / Q000473:pathology
D006454:Hemoglobins; D014807:Vitamin D; D002097:C-Reactive Protein; C104450:25-hydroxyvitamin D