대한신장학회

논문분류	춘계학술대회 초록집
제목	Serum 1,25-dihydroxyvitamin D better reflects renal parameters rather than 25-hydoxyvitamin in patients with glomerulonephritis
저자	Yu Ah Hong* 1, Hyun Seok Hwang1, Yoon Kyung Chang1, Cheol Whee Park1, Suk Young Kim1, Yoon Sik Chang1, Sungjin Chung1
출판정보	2016; 2016(1):
키워드	estimated glomerular filtration rate, Glomerulonephritis, kidney biopsy, proteinuria, vitamin D
초록	Background: Impaired vitamin D metabolism may contribute to the development and progression of chronic kidney disease (CKD). The purpose of the study was to determine associations of circulating vitamin D metabolites with the degree of proteinuria and impaired estimated glomerular filtration rate (eGFR) in patients with biopsy-proven glomerulonephritis. Methods: Blood samples for 25-hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D) levels were collected from 173 patients who admitted for renal biopsy. All clinical and laboratory data were obtained at the time of the renal biopsy, and therapeutic medication after renal biopsy was collected. Results: As serum 1,25D levels declined, renal function was significantly decreased (p<0.001). However, serum 25D levels were not different according to the change of eGFR (p=0.786). Serum albumin was significantly increased and total cholesterol and 24hr urine protein were significantly decreased in patients with the higher levels of 25D and 1,25D than in those with the lower values. The prevalence of nephrotic range proteinuria and moderate to severe renal dysfunction (eGFR ≤ 60ml/min/1.73m2) progressively increased with declining 1,25D, but not 25D. Multiple linear regression analysis showed that 25D was significantly correlated with serum albumin and total cholesterol (β=0.224, p=0.006; β=-0.263, p=0.001) and 1,25D was significantly correlated with eGFR, serum albumin and serum phosphorus (β=0.202, p=0.005; β=0.304, p<0.001; β=-0.161, p=0.024). In adjusted multivariable linear regression, eGFR and 24hr proteinuria were independently correlated only with 1,25D (β=0.154, p=0.018; β=-0.171, p=0.012). The lower level of 1,25D was associated with the frequent use of immunosuppressive agents after renal biopsy (p<0.001). riable linear regression, eGFR and 24hr proteinuria were independently correlated only with 1,25D (β=0.154, p=0.018; β=-0.171, p=0.012). The lower level of 1,25D was associated with the frequent use of immunosuppressive agents after renal biopsy (p<0.001). Conclusion: According to these results, it is noteworthy that circulating 1,25D may be superior to 25D as markers of renal outcome in patients with biopsy-proven glomerulonephritis.
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