Vitamin D and its associations with blood pressure in the Chronic Kidney Disease in Children (CKiD) cohort.
Study Goal
The researchers aimed to determine the association between Vitamin D (25OHD) levels and blood pressure in children with chronic kidney disease.
Results Summary
Lower baseline Vitamin D levels were associated with higher clinic systolic blood pressure, but no significant associations were found for diastolic blood pressure or ambulatory blood pressure indices. Longitudinal changes in Vitamin D did not significantly affect blood pressure.
Population
Children with chronic kidney disease.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Vitamin D (25OHD) | decrease | blood pressure (BP) | children and adults | - | inverse association | #1 |
baseline 25OHD levels | increase | clinic systolic BP index | participants in the CKiD study | 1.0% higher for every 10 ng/ml lower 25OHD | association | #2 |
baseline 25OHD levels | no change | clinic diastolic BP index | participants in the CKiD study | - | association was not significant | #3 |
longitudinal decreases in 25OHD | no change | clinic systolic BP index | participants in the CKiD study | - | not significantly associated | #4 |
longitudinal decreases in 25OHD | no change | clinic diastolic BP index | participants in the CKiD study | - | not significantly associated | #5 |
25OHD levels at baseline | no change | 24-h ABPM indices | participants in the CKiD study | - | no significant associations | #6 |
25OHD levels longitudinally | no change | 24-h ABPM indices | participants in the CKiD study | - | no significant associations | #7 |
Low 25OHD levels | increase | clinic systolic BP | children with CKD | - | associated with higher | #8 |
Vitamin D supplementation | neutral | BP control | high-risk patients (children with CKD) | - | might be a useful adjunctive treatment | #9 |
BACKGROUND: Vitamin D (25OHD) can modulate pathways and mechanisms that regulate blood pressure (BP). Observational studies in children and adults have shown an inverse association between 25OHD and BP. Studies evaluating associations between 25OHD and BP in pediatric chronic kidney disease are limited. METHODS: We evaluated the associations between 25OHD and BP using data from the Chronic Kidney Disease in Children (CKiD) study. Clinic or ambulatory BP index was defined as participant's BP divided by 95th age-sex-height-specific BP percentile, an index > 1 suggests hypertension. Primary outcomes of interest were changes in systolic and diastolic clinic and ambulatory BP indices over follow-up. Linear mixed-effects models were used to evaluate associations between BP indices and 25OHD. RESULTS: The study cohort consisted of 370 participants who contributed 970 person-visits. A subset of 194 participants with ambulatory BP data contributed 465 person-visits. There was an association between baseline 25OHD levels and clinic systolic BP index such that for every 10 ng/ml lower 25OHD, clinic systolic BP index was 1.0% higher (95%CI: 0.2-1.8, p = 0.016) between participants. The association between clinic diastolic BP index with baseline 25OHD was not significant. For within-person changes, longitudinal decreases in 25OHD were not significantly associated with concomitant increases in clinic systolic or diastolic BP index. There were no significant associations between 25OHD levels at baseline or longitudinally with 24-h ABPM indices. CONCLUSIONS: Low 25OHD levels were associated with higher clinic systolic BP in children with CKD. Vitamin D supplementation to maintain normal 25OHD levels might be a useful adjunctive treatment in optimizing BP control in these high-risk patients.