title: Is the serum vitamin D level at the time of hospital-acquired acute kidney injury diagnosis associated with prognosis?
abstract: BACKGROUND
  Low circulating vitamin D levels have been suggested to potentially contribute to acute complications in critically ill patients. However, in patients with acute kidney injury (AKI), whether vitamin D deficiency occurs and is a potential contributor to worse early outcomes at the time of AKI diagnosis remains unclear.
  
  
  RESULTS
  Two hundred patients with AKI were enrolled in our study. Healthy subjects and critically ill patients without AKI served as controls. Serum vitamin D concentrations were measured in the three groups. The patients with AKI were followed up for 90 days and grouped according to median serum vitamin D concentrations. In addition, vitamin D receptor polymorphisms (BsmI and FokI) were measured in these patients; they were also followed up for 90 days and grouped according to vitamin D receptor gene mutations. Low serum 1,25-dihydroxyvitamin D levels (59.56±53.00 pmol/L) were detected in patients with AKI and decreased with increasing severity of AKI. There were no significant findings with respect to 25-hydroxyvitamin D. The 90-day survival curves of individuals with high vitamin D concentrations showed no significant differences compared with the curves of individuals with low concentrations. The survival curves of patients with BB/Bb or FF/Ff genotypes also showed no significant differences compared with patients with bb or ff genotypes. In Cox regression analysis, the vitamin D status in patients with AKI was not an independent prognostic factor as adjusted by age, sex, Sequential Organ Failure Assessment score, or vitamin D receptor polymorphisms.
  
  
  CONCLUSIONS
  Patients with AKI manifested a marked decrease in the 1,25-dihydroxyvitamin D level at the time of AKI diagnosis, and the degree of 1,25-dihydroxyvitamin D deficiency increased with the severity of AKI. No association between the serum vitamin D level at the time of AKI diagnosis and 90-day all-cause mortality was found in patients with AKI.
authors.affiliation: Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Lingyun
authors.initials: L
authors.lastname: Lai
authors.forename: Jing
authors.initials: J
authors.lastname: Qian
authors.forename: Yanjiao
authors.initials: Y
authors.lastname: Yang
authors.forename: Qionghong
authors.initials: Q
authors.lastname: Xie
authors.forename: Huaizhou
authors.initials: H
authors.lastname: You
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhou
authors.forename: Shuai
authors.initials: S
authors.lastname: Ma
authors.forename: Chuanming
authors.initials: C
authors.lastname: Hao
authors.forename: Yong
authors.initials: Y
authors.lastname: Gu
authors.forename: Feng
authors.initials: F
authors.lastname: Ding
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014807:Vitamin D / Q000097:blood*
chemical_list: D014807:Vitamin D