title: Serum 1,25-dihydroxyvitamin d and the development of kidney dysfunction in a Japanese community.
abstract: BACKGROUND
  Recent evidence indicates that vitamin D deficiency is associated with an increased risk of renal impairment, but studies addressing the influence of vitamin D deficiency on the development of chronic kidney disease (CKD) in the general Asian population have been few.
  
  
  RESULTS
  A total of 2,417 community-dwelling individuals without CKD stage 3-5 aged ≥40 years were followed for 5 years (mean age, 60 years; women, 59.1%). The cumulative incidence of CKD stage 3-5, defined as estimated glomerular filtration rate (eGFR) <60ml·min(-1)·1.73m(-2), and the rate of decline in eGFR according to quartile of serum 1,25-dihydroxyvitamin D (1,25(OH)2D), were estimated. During follow-up, 378 subjects experienced CKD stage 3-5. The age- and sex-adjusted incidence of CKD stage 3-5 increased significantly with decreasing serum 1,25(OH)2D (P for trend <0.001). Compared with the highest quartile, the multivariate-adjusted odds ratio for the development of CKD stage 3-5 was 1.90 in the lowest quartile and 1.74 in the second lowest quartile, after adjusting for confounding factors. Additionally, lower serum 1,25(OH)2D was significantly associated with a greater change in eGFR (-0.10ml·min(-1)·1.73m(-2)·year(-1) per 10-pg/ml decrement in serum 1,25(OH)2D).
  
  
  CONCLUSIONS
  Lower serum 1,25(OH)2D is a significant risk factor for the development of CKD stage 3-5 in the general Asian population.
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Izumaru
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nagata
authors.forename: Tomoko
authors.initials: T
authors.lastname: Usui
authors.forename: Daigo
authors.initials: D
authors.lastname: Yoshida
authors.forename: Koji
authors.initials: K
authors.lastname: Yonemoto
authors.forename: Masayo
authors.initials: M
authors.lastname: Fukuhara
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
mesh_terms: D000367:Age Factors; D000368:Aged; D002117:Calcitriol / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D007674:Kidney Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology
chemical_list: D002117:Calcitriol