The Serum 24,25-dihydroxyvitamin D Concentration, a Marker of Vitamin D Catabolism, is Reduced in Chronic Kidney Disease

Overview

Journal Kidney Int

Publisher Elsevier

Specialty Nephrology

Date 2012 Jun 1

PMID 22648296

Citations 73

Authors

Cortney R Bosworth

Gregory Levin

Cassianne Robinson-Cohen

Andrew N Hoofnagle

John Ruzinski

Bessie Young

Stephen M Schwartz

Jonathan Himmelfarb

Bryan Kestenbaum

Ian H de Boer

Affiliations

Soon will be listed here.

Abstract

Chronic kidney disease is characterized, in part, as a state of decreased production of 1,25-dihydroxyvitamin D (1,25(OH)(2)D); however, this paradigm overlooks the role of vitamin D catabolism. We developed a mass spectrometric assay to quantify serum concentration of 24,25-dihydroxyvitamin D (24,25(OH)(2)D), the first metabolic product of 25-hydroxyvitamin D (25(OH)D) by CYP24A1, and determined its clinical correlates and associated outcomes among 278 participants with chronic kidney disease in the Seattle Kidney Study. For eGFRs of 60 or more, 45-59, 30-44, 15-29, and under 15 ml/min per 1.73 m(2), the mean serum 24,25(OH)(2)D concentrations significantly trended lower from 3.6, 3.2, 2.6, 2.6, to 1.7 ng/ml, respectively. Non-Hispanic black race, diabetes, albuminuria, and lower serum bicarbonate were also independently and significantly associated with lower 24,25(OH)(2)D concentrations. The 24,25(OH)(2)D concentration was more strongly correlated with that of parathyroid hormone than was 25(OH)D or 1,25(OH)(2)D. A 24,25(OH)(2)D concentration below the median was associated with increased risk of mortality in unadjusted analysis, but this was attenuated with adjustment for potential confounding variables. Thus, chronic kidney disease is a state of stagnant vitamin D metabolism characterized by decreases in both 1,25(OH)(2)D production and vitamin D catabolism.

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