Session Information
Date: Sunday, November 5, 2017
Session Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster I: Biomarkers and Outcomes
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Vitamin D insufficiency/deficiency is common in SLE. Replacement therapy may help renal disease activity. We asked whether low vitamin D predicted later organ damage.
Methods: We considered all follow-up after a patient’s first measure of vitamin D. The first measure of vitamin D usually occurred in late 2009 or 2010 for existing patients and at the first visit of new patients after that. The patients were categorized based on their first measure of vitamin D as <20 ng/mL versus 20+ ng/mL. A total of 1,392 SLE patients were included in the analysis. At the first visit when vitamin D was measured, 27.3% had levels of 25-hydroxy vitamin D <20 ng/ml. The SLE patients were: 92% female, mean age 47.3 years and ethnicity 50% Caucasian, 41% African American.
Results: Risk of lifetime organ damage was calculated, using SLICC/ACR Damage Index.
Table 1: Risk of organ damage adjusted for age, gender and ethnicity.
|
Categorical Vitamin D (< 20 ng/ml as abnormal) |
||||
|
RR (95% CI) |
P-Value |
Adjusted RR (95% CI) |
Adj. P-Value |
|
|
Ocular Damage |
0.97 (0.76,1.25) |
0.83 |
1.10 (0.86,1.4) |
0.4388 |
|
Neuropsychiatric Damage |
0.95 (0.73,1.24) |
0.7222 |
1.04 (0.79,1.36) |
0.7979 |
|
Renal Damage |
1.87 (1.23,2.84) |
0.0033 |
1.66 (1.08,2.54) |
0.0206 |
|
Pulmonary damage |
1.01 (0.74,1.38) |
0.9321 |
1.04 (0.77,1.41) |
0.7888 |
|
Cardiovascular Damage |
1.11 (0.77,1.59) |
0.5882 |
1.20 (0.83,1.74) |
0.3396 |
|
Peripheral Vascular Damage |
1.18 (0.7,2) |
0.5346 |
1.23 (0.75,2) |
0.4134 |
|
Gastrointestinal Damage |
0.91 (0.65,1.26) |
0.553 |
1.04 (0.74,1.46) |
0.8093 |
|
Musculoskeletal Damage |
1.03 (0.82,1.28) |
0.8208 |
1.09 (0.86,1.37) |
0.4706 |
|
Skin Damage |
1.69 (1.11,2.57) |
0.0145 |
1.22 (0.8,1.84) |
0.3561 |
|
Total Damage |
1.11 (0.97,1.28) |
0.1246 |
1.17 (1.02,1.33) |
0.0245 |
Conclusion: Low vitamin D associated with total damage and with End Stage Renal Disease. As vitamin D supplementation reduces proteinuria, this further suggests that vitamin D supplementation should be part of treatment of lupus nephritis. Surprisingly, low vitamin D did not associate with musculoskeletal damage (including with the subtype of osteoporotic fractures).
To cite this abstract in AMA style:
Petri M, Fu W, Goldman D. Low Vitamin D Is Associated with End Stage Renal Disease in Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/low-vitamin-d-is-associated-with-end-stage-renal-disease-in-systemic-lupus-erythematosus/. Accessed July 23, 2019.« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/low-vitamin-d-is-associated-with-end-stage-renal-disease-in-systemic-lupus-erythematosus/