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Christodoulou, Marilena 
ORCID: https://orcid.org/0000-0002-5637-3768, Aspray, Terence J., Piec, Isabelle ORCID: https://orcid.org/0000-0002-0648-1330, Fraser, William D. and Schoenmakers, Inez
and
the VDOP Trial group
(2024)
Alterations in regulators of the renal-bone axis, inflammation and iron status in older people with early renal impairment and the effect of Vitamin D supplementation.
Age and Ageing, 53 (5).
ISSN 0002-0729
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Abstract
Context: Chronic kidney disease (CKD) leads to alterations in fibroblast growth factor 23 (FGF23) and the renal-bone axis. This may be partly driven by altered inflammation and iron status. Vitamin D supplementation may reduce inflammation. Objective and methods: Older adults with early CKD (estimated glomerular filtration rate (eGFR) 30–60 ml/min/1.73 m2; CKDG3a/b; n = 35) or normal renal function (eGFR >90 ml/min/1.73 m2; CKDG1; n = 35) received 12,000, 24,000 or 48,000 IU D3/month for 1 year. Markers of the renal-bone axis, inflammation and iron status were investigated pre- and post-supplementation. Predictors of c-terminal and intact FGF23 (cFGF23; iFGF23) were identified by univariate and multivariate regression. Results: Pre-supplementation, comparing CKDG3a/b to CKDG1, plasma cFGF23, iFGF23, PTH, sclerostin and TNFα were significantly higher and Klotho, 1,25-dihydroxyvitamin D and iron were lower. Post-supplementation, only cFGF23, 25(OH)D and IL6 differed between groups. The response to supplementation differed between eGFR groups. Only in the CKDG1 group, phosphate decreased, cFGF23, iFGF23 and procollagen type I N-propeptide increased. In the CKDG3a/b group, TNFα significantly decreased, and iron increased. Plasma 25(OH)D and IL10 increased, and carboxy-terminal collagen crosslinks decreased in both groups. In univariate models cFGF23 and iFGF23 were predicted by eGFR and regulators of calcium and phosphate metabolism at both time points; IL6 predicted cFGF23 (post-supplementation) and iFGF23 (pre-supplementation) in univariate models. Hepcidin predicted post-supplementation cFGF23 in multivariate models with eGFR. Conclusion: Alterations in regulators of the renal-bone axis, inflammation and iron status were found in early CKD. The response to vitamin D3 supplementation differed between eGFR groups. Plasma IL6 predicted both cFGF23 and iFGF23 and hepcidin predicted cFGF23.
| Item Type: | Article |
|---|---|
| Additional Information: | Acknowledgements: The VDOP Trial group study group comprises Terry J Aspray, Roger M Francis, Elaine McColl, Thomas Chadwick, Ann Prentice and Inez Schoenmakers and was responsible for the design, implementation, monitoring and reporting of the main outcomes trial [33, 39]. Data Availability: Primary data and outcomes were published per EUDRACT protocol. |
| Uncontrolled Keywords: | fibroblast growth factor 23,inflammation markers,iron status,older people,renal impairment,vitamin d,ageing,geriatrics and gerontology ,/dk/atira/pure/subjectarea/asjc/1300/1302 |
| Faculty \ School: | Faculty of Science > School of Pharmacy Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 07 May 2024 11:31 |
| Last Modified: | 15 Jun 2024 00:09 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/95083 |
| DOI: | 10.1093/ageing/afae096 |
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