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Vitamin D and its associations with blood pressure in the Chronic Kidney Disease in Children (CKiD) cohort.

Pediatric nephrology (Berlin, Germany)
November 1, 2024
Juhi Kumar et al. (6 authors)
Journal ArticleMulticenter StudyHuman Study
Study Details

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

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
AdolescentChildFemaleHumansMaleBlood PressureBlood Pressure Monitoring, AmbulatoryCohort StudiesHypertensionProspective StudiesRenal Insufficiency, ChronicVitamin DVitamin D Deficiency
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Research Impact Scores
APT Score0.05
Weight Score2.34
Normalized Score0.61
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