25-hydroxyvitamin D, Fibroblast Growth Factor 23, and Risk of Acute Kidney Injury Over 20 Years of Follow-Up.
25-hydroxyvitamin D, Fibroblast Growth Factor 23, and Risk of Acute Kidney Injury Over 20 Years of Follow-Up.
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DOI：
10.1016/j.ekir.2021.02.009
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发表时间：
2021-05
影响因子：
6
通讯作者：
Matsushita K
中科院分区：
文献类型：
--
作者：
Ishigami J;Grams ME;Michos ED;Lutsey PL;Matsushita K
低血清25-羟基维生素D水平已被确定为危重患者急性肾损伤（阿基）的危险因素。在一般人群中，低25-羟基维生素D水平是否与阿基住院的长期发生率相关尚不清楚。在参加社区动脉粥样硬化风险（ARIC）研究的12，380名参与者（平均年龄，57岁; 24%黑人）中，参加了第2次访视（1990-1992年），我们探讨了血清25-羟基维生素D与阿基住院事件的相关性。多变量考克斯模型用于估计风险比（HR）。我们还研究了血清成纤维细胞生长因子23（FGF 23）与阿基的关系。在中位随访24.3年期间，2145名参与者因阿基住院（粗发生率：8.3; 95%置信区间[CI]：8.0-8.7，每1,000人-年）。多变量考克斯模型（包括肾功能调整），较低的25-羟基维生素D和较高的FGF 23水平均与阿基风险增加显著相关。（HR：1.35; 95% CI：1.17-1.54，25-羟基维生素D的最低与最高四分位数，HR：1.19; 95% CI：1.05-1.36，对于FGF 23的最高四分位数与最低四分位数）。无论阿基是否是住院的主要诊断，以及当将偶发慢性肾脏疾病（CKD）或心血管疾病（CVD）作为随时间变化的协变量进行调整时，该相关性在人口统计学和临床亚组中一致。在社区的中老年人中，低25-羟基维生素D和高FGF 23水平与阿基风险增加独立相关。未来的研究应探讨这些骨矿物质代谢标志物与肾损伤的潜在机制。
Low serum 25-hydroxyvitamin D levels have been identified as a risk factor for acute kidney injury (AKI) among critically ill patients. Whether low 25-hydroxyvitamin D levels are associated with long-term incidence of hospitalization with AKI in the general population is unknown. Among 12,380 participants (mean age, 57 years; 24% black) in the Atherosclerosis Risk in Communities (ARIC) Study who attended visit 2 (1990–1992), we explored the association of serum 25-hydroxyvitamin D with incident hospitalization with AKI. Multivariable Cox models were used to estimate hazard ratios (HRs). We also examined the association of serum fibroblast growth factor 23 (FGF23) with AKI. During a median follow-up of 24.3 years, 2145 participants had incident hospitalization with AKI (crude incidence rate: 8.3; 95% confidence interval [CI]: 8.0–8.7, per 1,000 person-years). In multivariable Cox models (including adjustment for kidney function), lower 25-hydroxyvitamin D and higher FGF23 levels were each significantly associated with an increased risk of AKI (HR: 1.35; 95% CI: 1.17–1.54, for lowest vs. highest quartile for 25-hydroxyvitamin D, and HR: 1.19; 95% CI: 1.05–1.36, for highest vs. lowest quartile for FGF23). The association was consistent across demographic and clinical subgroups, regardless of whether AKI was the primary diagnosis for hospitalization, and when adjusting for incident chronic kidney disease (CKD) or cardiovascular disease (CVD) as a time-varying covariate. Among middle- to older-age adults in the community, low 25-hydroxyvitamin D and high FGF23 levels were independently associated with an increased risk of AKI. Future studies should explore underlying mechanisms linking these bone mineral metabolism markers with kidney injury.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
影响因子：
13.6
作者：
Leaf, David E.;Jacob, Kirolos A.;Waikar, Sushrut S.
通讯作者：
Waikar, Sushrut S.
DOI：
10.1053/j.ajkd.2012.04.014
发表时间：
2012-10
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Kendrick J;Cheung AK;Kaufman JS;Greene T;Roberts WL;Smits G;Chonchol M;HOST (Homocysteinemia in Kidney and End Stage Renal Disease) Study Investigators
通讯作者：
HOST (Homocysteinemia in Kidney and End Stage Renal Disease) Study Investigators
影响因子：
13.2
作者：
Grams, Morgan E.;Rebholz, Casey M.;Coresh, Josef
通讯作者：
Coresh, Josef
影响因子：
2.5
作者：
de Bragança AC;Volpini RA;Mehrotra P;Andrade L;Basile DP
通讯作者：
Basile DP