Kidney Week

Abstract: TH-PO430

Effect of Vitamin D Repletion on Cardiorenal Biomarkers and Vascular Function in a High-Risk African American Cohort

Session Information

• Hypertension and CVD: Epidemiology, Risk Factors, Prevention
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

• Sinha, Satyesh K., Charles R Drew University of Medicine and Science, Los Angeles, California, United States

Satyesh K. Sinha,

• Lee, Jae eun, Jackson State Univerity, Madison, Mississippi, United States

Jae eun Lee,

• Sun, Ling, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Ling Sun,

• Norris, Keith C., David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Keith C. Norris,

• Nicholas, Susanne B., David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Susanne B. Nicholas,

Background

African Americans (AAs) suffer disproportionately from cardiovascular disease and chronic kidney disease (CKD), and eighty percent of AAs are vitamin D deficient. The effects of vitamin D on vascular and renal health in patients with CKD have been contradictory in part due to different study designs. We previously showed that vitamin D repletion significantly decreased markers of inflammation and oxidative stress in a high-risk cohort of AAs with controlled hypertension and preserved renal function. In this study, we examined the effect of vitamin D on c-terminal fibroblast growth factor-23 (cFGF23), plasminogen activator inhibitor-1 (PAI-1), and vascular and renal function in a subset of the cohort.

Methods

We performed a randomized, placebo-controlled study of high-risk AAs (N=65) with vitamin D deficiency treated with 100,000 IU vitamin D3 or placebo every 4 weeks for 12 weeks. We measured eGFR (MDRD) albumin-to-creatinine ratio (ACR), and quantified plasma cardiorenal biomarkers (cFGF23 and PAI-1 by ELISA) and determinants of vascular function (pulse wave velocity, augmentation index, ambulatory systolic and diastolic blood pressure). We performed multiple regression analysis controlling for the placebo-treated group to understand the relationship between FGF23 and PAI-1 with cardiovascular and renal risk factors.

Results

Vitamin D3 levels increased (p<0.0001) and iPTH levels decreased (p=0.0060) with vitamin D3 repletion. There was no change in systolic/diastolic blood pressure and no correlation between vitamin D3 repletion and levels of cFGF23 or PAI-1. However, logPAI-1 was associated with improved augmentation index (p=0.045) and a trend for improved ACR (p=0.074), and reduced PAI-1 levels were associated with improved eGFR (p<0.0300). There was a trend for reduced FGF23 with improved augmentation index (p=0.078); and for logcFGF23 with improved pulse wave velocity (p<0.069).

Conclusion

Vitamin D3 repletion may modulate vascular and renal function in AAs with controlled hypertension and vitamin D3 deficiency. Further study may provide a better understanding of the genetic predisposition of vitamin D repletion on vascular and renal function in high-risk AAs with vitamin D deficiency.

Funding

• Other NIH Support