Abstract: FR-PO240
Association of Serum Vitamin D Levels with Cardiovascular and All-Cause Mortality among Kidney Stone Formers: The National Health and Nutrition Examination Survey, 1988-1994 and 2007-2018
Session Information
- Mineral Bone Disease: Transplant and Kidney Stones
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Cadore Guzzo, Eduardo, Brown University, Providence, Rhode Island, United States
- Raker, Christina A., Brown University, Providence, Rhode Island, United States
- Tang, Jie, Brown University, Providence, Rhode Island, United States
Background
The associations between serum 25-hydroxy-vitamin D (25D) levels and mortality outcomes in individuals with kidney stone disease (KSD) remain unclear.
Methods
We assessed the relationship between 25D levels and mortality among a sample of US adults (age ≥20 years), using the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2011-2018, and its Linked Mortality File (through 2019). KSD was defined as a self-report of any previous episode of kidney stone. Cox proportional hazard regression analyses were used to estimate the risks of all-cause and cardiovascular disease (CVD) mortality.
Results
We included 42,207 participants in the analysis; among them, 3,378 had KSD. Stone formers (SF) tended to be male, white, and older, had a higher BMI, and were more likely to have hypertension, diabetes, and CVD. However, the estimated GFR was similar between SF and non-SF. Among SF, the mean serum 25D was 69.1 ng/ml, there were 749 all-cause deaths and 209 CVD deaths with a median follow-up of 7.8 years, whereas among non-SF, the mean serum 25D was 66.6 ng/ml, and there were 7,761 all-cause deaths and 2,231 CVD deaths with a median follow up of 10.3 years. In both unadjusted and adjusted analyses, unlike non-SF where higher serum 25D was associated with a lower risk for death and CVD death, higher serum 25D was associated with a lower risk for CVD death but not all-cause death in SF [Table].
Conclusion
Among SF, higher serum 25D was associated with a reduced risk for CVD death but not all-cause death. Future prospective studies are needed to clarify the effect of 25D on survival among SF.
Hazard ratios for 25D* and mortality by KSD
| Stone Formers | Non-Stone Formers | |||||||
| CVD Mortality | All-cause Mortality | CVD Mortality | All-cause Mortality | |||||
| Model | HR | 95% CI | HR | 95% CI | HR | 95% CI | HR | 95% CI |
| Unadjusted | 0.92 | 0.84-0.99 | 0.98 | 0.93-1.03 | 0.92 | 0.88-0.95 | 0.93 | 0.91-0.95 |
| Adjusted | 0.89 | 0.82-0.97 | 0.97 | 0.92-1.01 | 0.94 | 0.91-0.97 | 0.95 | 0.93-0.97 |
*Per 10 nmol/L. **Age, sex, race/ethnicity, education, health insurance, BMI, hypertension, diabetes, CVD, smoking, alcohol intake, thiazide use, leisure physical activity intensity; dietary intake of total fluid, sodium, potassium, magnesium; serum total cholesterol, HDL, eGFR.
Funding
- Private Foundation Support