Hypovitaminosis D Is Prevalent in Patients With Renal AL Amyloidosis and Associated With Renal Outcome
IntroductionVitamin D deficiency is common, but no data have been reported on vitamin D levels in light chain (AL) amyloidosis.Patients and MethodsIn this exploratory study, stored serum samples from 173 patients with newly diagnosed AL amyloidosis were analyzed for vitamin studies which included 25...
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Frontiers Media S.A.
2022-06-01
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author | Eli Muchtar Matthew T. Drake Matthew T. Drake Nelson Leung Nelson Leung Angela Dispenzieri Martha Q. Lacy Francis K. Buadi David Dingli Suzanne R. Hayman Prashant Kapoor Yi Lisa Hwa Amie Fonder Miriam Hobbs Wilson Gonsalves Taxiarchis V. Kourelis Rahma Warsame Stephen Russell Ronald S. Go Moritz Binder Robert A. Kyle S. Vincent Rajkumar Shaji K. Kumar Morie A. Gertz |
author_facet | Eli Muchtar Matthew T. Drake Matthew T. Drake Nelson Leung Nelson Leung Angela Dispenzieri Martha Q. Lacy Francis K. Buadi David Dingli Suzanne R. Hayman Prashant Kapoor Yi Lisa Hwa Amie Fonder Miriam Hobbs Wilson Gonsalves Taxiarchis V. Kourelis Rahma Warsame Stephen Russell Ronald S. Go Moritz Binder Robert A. Kyle S. Vincent Rajkumar Shaji K. Kumar Morie A. Gertz |
author_sort | Eli Muchtar |
collection | DOAJ |
description | IntroductionVitamin D deficiency is common, but no data have been reported on vitamin D levels in light chain (AL) amyloidosis.Patients and MethodsIn this exploratory study, stored serum samples from 173 patients with newly diagnosed AL amyloidosis were analyzed for vitamin studies which included 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)2D] and vitamin D binding protein (DBP). Measurements were made by liquid chromatography-tandem mass spectrometry. Kidney survival and overall survival (OS) were assessed in association to vitamin D status.ResultsCardiac and kidney involvement occurred in 69% and 63% of patients, respectively. 25(OH)D deficiency (<20 ng/mL) was seen in 56.6% of the patients and was notably found among patients with heavy proteinuria (96%), hypoalbuminemia (84.3%) and morbidly obese patients (68.3%). Heavy proteinuria (>5 gr/24-h) and vitamin D supplementation were independent predictors of 25(OH)D level on nominal multivariate regression analysis. 1,25(0H)2D deficiency was noted in 37.6% of patients and was independently associated with low eGFR and hypoalbuminemia. Progression to ESRD occurred in 23.7% of evaluable patients. Patients who progressed to ESRD had lower serum 25(OH)D and 1,25(OH)2D levels compared to those who did not progress to ESRD. On a multivariate analysis, severe 25(OH)D deficiency was an independent predictor of progression to ESRD as was renal stage, while 1,25(OH)2D deficiency was not.ConclusionsHypovitaminosis D is common in AL amyloidosis, particularly among patients with heavy proteinuria. Severe 25(OH)D deficiency at time of diagnosis predicts progression to ESRD. |
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spelling | doaj.art-ba524f74cc864fed94a7e7acb5a376332022-12-22T02:38:48ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-06-011310.3389/fendo.2022.891712891712Hypovitaminosis D Is Prevalent in Patients With Renal AL Amyloidosis and Associated With Renal OutcomeEli Muchtar0Matthew T. Drake1Matthew T. Drake2Nelson Leung3Nelson Leung4Angela Dispenzieri5Martha Q. Lacy6Francis K. Buadi7David Dingli8Suzanne R. Hayman9Prashant Kapoor10Yi Lisa Hwa11Amie Fonder12Miriam Hobbs13Wilson Gonsalves14Taxiarchis V. Kourelis15Rahma Warsame16Stephen Russell17Ronald S. Go18Moritz Binder19Robert A. Kyle20S. Vincent Rajkumar21Shaji K. Kumar22Morie A. Gertz23Division of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDepartment of Endocrinology and Kogod Center of Aging, Mayo Clinic College of Medicine, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesDivision of Hematology, Mayo Clinic, Rochester, MN, United StatesIntroductionVitamin D deficiency is common, but no data have been reported on vitamin D levels in light chain (AL) amyloidosis.Patients and MethodsIn this exploratory study, stored serum samples from 173 patients with newly diagnosed AL amyloidosis were analyzed for vitamin studies which included 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)2D] and vitamin D binding protein (DBP). Measurements were made by liquid chromatography-tandem mass spectrometry. Kidney survival and overall survival (OS) were assessed in association to vitamin D status.ResultsCardiac and kidney involvement occurred in 69% and 63% of patients, respectively. 25(OH)D deficiency (<20 ng/mL) was seen in 56.6% of the patients and was notably found among patients with heavy proteinuria (96%), hypoalbuminemia (84.3%) and morbidly obese patients (68.3%). Heavy proteinuria (>5 gr/24-h) and vitamin D supplementation were independent predictors of 25(OH)D level on nominal multivariate regression analysis. 1,25(0H)2D deficiency was noted in 37.6% of patients and was independently associated with low eGFR and hypoalbuminemia. Progression to ESRD occurred in 23.7% of evaluable patients. Patients who progressed to ESRD had lower serum 25(OH)D and 1,25(OH)2D levels compared to those who did not progress to ESRD. On a multivariate analysis, severe 25(OH)D deficiency was an independent predictor of progression to ESRD as was renal stage, while 1,25(OH)2D deficiency was not.ConclusionsHypovitaminosis D is common in AL amyloidosis, particularly among patients with heavy proteinuria. Severe 25(OH)D deficiency at time of diagnosis predicts progression to ESRD.https://www.frontiersin.org/articles/10.3389/fendo.2022.891712/fullnephrotic syndromedialysisproteinuriakidney survivalvitamin D |
spellingShingle | Eli Muchtar Matthew T. Drake Matthew T. Drake Nelson Leung Nelson Leung Angela Dispenzieri Martha Q. Lacy Francis K. Buadi David Dingli Suzanne R. Hayman Prashant Kapoor Yi Lisa Hwa Amie Fonder Miriam Hobbs Wilson Gonsalves Taxiarchis V. Kourelis Rahma Warsame Stephen Russell Ronald S. Go Moritz Binder Robert A. Kyle S. Vincent Rajkumar Shaji K. Kumar Morie A. Gertz Hypovitaminosis D Is Prevalent in Patients With Renal AL Amyloidosis and Associated With Renal Outcome Frontiers in Endocrinology nephrotic syndrome dialysis proteinuria kidney survival vitamin D |
title | Hypovitaminosis D Is Prevalent in Patients With Renal AL Amyloidosis and Associated With Renal Outcome |
title_full | Hypovitaminosis D Is Prevalent in Patients With Renal AL Amyloidosis and Associated With Renal Outcome |
title_fullStr | Hypovitaminosis D Is Prevalent in Patients With Renal AL Amyloidosis and Associated With Renal Outcome |
title_full_unstemmed | Hypovitaminosis D Is Prevalent in Patients With Renal AL Amyloidosis and Associated With Renal Outcome |
title_short | Hypovitaminosis D Is Prevalent in Patients With Renal AL Amyloidosis and Associated With Renal Outcome |
title_sort | hypovitaminosis d is prevalent in patients with renal al amyloidosis and associated with renal outcome |
topic | nephrotic syndrome dialysis proteinuria kidney survival vitamin D |
url | https://www.frontiersin.org/articles/10.3389/fendo.2022.891712/full |
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