title: Biomarkers of Vitamin D Status and Risk of ESRD.
abstract: BACKGROUND
  Disordered mineral metabolism is characteristic of decreased kidney function. However, the prospective associations between circulating levels of vitamin D binding protein, vitamin D, and end-stage renal disease (ESRD) have not been extensively evaluated in epidemiologic studies.
  
  
  METHODS
  Nested case-control study.
  
  
  METHODS
  Middle-aged black and white men and women from 4 US communities.
  
  
  METHODS
  Baseline levels of vitamin D binding protein, 25-hydroxyvitamin D (25[OH]D), and 1,25-dihydroxyvitamin D (1,25[OH]2D) were measured in blood samples collected at study visit 4 (1996-1998) of the ARIC (Atherosclerosis Risk in Communities) Study.
  
  
  RESULTS
  ESRD cases (n=184) were identified through hospitalization diagnostic codes from 1996 to 2008 and were frequency matched to controls (n=251) on categories of estimated glomerular filtration rate, albuminuria, diabetes mellitus, sex, and race.
  
  
  METHODS
  Logistic regression was used to estimate the association between mineral metabolism biomarkers (vitamin D binding protein, 25(OH)D, and 1,25(OH)2D) and incident ESRD, adjusting for age, sex, race, estimated glomerular filtration rate, albuminuria, diabetes mellitus, hypertension, education, specimen type, and serum levels of calcium, phosphate, and parathyroid hormone.
  
  
  RESULTS
  Higher vitamin D binding protein levels were associated with elevated risk for incident ESRD (OR, 1.76; 95% CI, 1.22-2.54; P=0.003). Higher free and bioavailable 25(OH)D levels were associated with reduced risk for incident ESRD (ORs of 0.65 [95% CI, 0.46-0.92; P=0.02] and 0.63 [95% CI, 0.43-0.91; P=0.02] for free and bioavailable 25[OH]D, respectively). There was no association between ESRD and overall levels of 25(OH)D (OR, 0.83; 95% CI, 0.58-1.19; P=0.3) or 1,25(OH)2D (OR, 0.73; 95% CI, 0.48-1.13; P=0.2).
  
  
  CONCLUSIONS
  Lack of direct measurement of free and bioavailable vitamin D.
  
  
  CONCLUSIONS
  In the general population, blood levels of vitamin D binding protein were positively associated and blood levels of free and bioavailable 25(OH)D were inversely associated with new-onset ESRD during follow-up.
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: crebhol1@jhu.edu.
authors.forename: Casey M
authors.initials: CM
authors.lastname: Rebholz
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Morgan E
authors.initials: ME
authors.lastname: Grams
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Lutsey
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, WA.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Hoofnagle
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Misialek
authors.affiliation: William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.
authors.forename: Lesley A
authors.initials: LA
authors.lastname: Inker
authors.affiliation: William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Levey
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.affiliation: Division of Nephrology, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, CA.
authors.forename: Chi-Yuan
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Kimmel
authors.affiliation: Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA; Section of Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, MN.
authors.forename: John H
authors.initials: JH
authors.lastname: Eckfeldt
authors.affiliation: Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014809:Vitamin D-Binding Protein / Q000097:blood*
chemical_list: D015415:Biomarkers; D014809:Vitamin D-Binding Protein; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; C104450:25-hydroxyvitamin D
keywords: Biological markers; chronic renal failure; end-stage renal disease (ESRD); mineral metabolism biomarker; risk factors; vitamin D; vitamin D insufficiency; vitamin D-binding protein