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Abstract Number: 665

Low Vitamin D Is Associated with End Stage Renal Disease in Systemic Lupus Erythematosus

Michelle Petri1, Wei Fu2 and Daniel Goldman2, 1Medicine (Rheumatology), Division of Rheumatology, Johns Hopkins University School of Medicine, MD, USA, Baltimore, MD, 2Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Lupus nephritis, renal disease and systemic lupus erythematosus (SLE), Vitamin D

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Session Information

Date: Sunday, November 5, 2017

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).


Disclosure: M. Petri, Anthera Inc, 5,GlaxoSmithKline, 5,EMD Serono, 5,Eli Lilly and Company, 5,Bristol Meyer Squibb, 5,Amgen, 5,United Rheumatology, 5,Global Academy, 5,Exagen, 2; W. Fu, None; D. Goldman, None.

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 .
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