Increasing use of vitamin D supplementation in the chronic renal insufficiency cohort study

Laura H. Mariani*, Matthew T. White, Justine Shults, Cheryl A.M. Anderson, Harold I. Feldman, Myles Wolf, Peter P. Reese, Michelle R. Denburg, Raymond R. Townsend, Joan C. Lo, Anne R. Cappola, Dean Carlow, Crystal A. Gadegbeku, Susan Steigerwalt, Mary B. Leonard

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objective: This study examined rates and determinants of vitamin D supplementation among Chronic Renal Insufficiency Cohort (CRIC) participants and determined the association between dose and 25-hydroxyvitamin D (25(OH)D) level. The 2010 Institute of Medicine Report noted a significant increase in vitamin D supplementation in the general population, but use in chronic kidney disease (CKD) is unknown. Methods: CRIC is a multicenter prospective observational cohort study of 3,939 participants with a median baseline age of 60 and an estimated glomerular filtration rate (eGFR) of 42.1mL/minute per 1.73m2. Of the cohort, 54.9% was male, 42.1% were Black, and 48.4% were diabetic. Multivariable logistic generalized estimating equations were used to examine determinants of supplementation use assessed annually between 2003 and 2011. Cross-sectional linear regression models, based on a subset of 1,155 participants, assessed associations between supplement dose and 25(OH)D level, measured by high-performance liquid chromatography coupled with tandem mass spectrometry. Results: The proportion of participants reporting supplement use increased (P < .0001), from 10% at baseline to 44% at 7-year follow-up visits. This was largely due to initiation of products containing only ergocalciferol or cholecalciferol. The odds of supplementation were greater in older, female, non-Black, married participants with greater education and lower body mass index. Among participants taking supplementation, dose was positively associated with 25(OH)D level, adjusted for race, season, diabetes, dietary intake, eGFR, and proteinuria. Only 3.8% of non-Black and 16.5% of Black participants taking a supplement were deficient (<20ng/mL), whereas 22.7% of non-Black and 62.4% of Black participants not reporting supplement use were deficient. Conclusions: Vitamin D supplementation rates rose significantly among CRIC participants over 7years of follow-up and were associated with greater serum 25(OH)D levels. Studies of vitamin D levels on clinical outcomes in CKD and future vitamin D interventional studies should consider these changes in supplementation practices.

Original languageEnglish (US)
Pages (from-to)186-193
Number of pages8
JournalJournal of Renal Nutrition
Volume24
Issue number3
DOIs
StatePublished - May 2014

ASJC Scopus subject areas

  • Nephrology
  • Nutrition and Dietetics
  • Medicine (miscellaneous)

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