Lupus

Important role for vitamin D in lupus


A lupus expert has called for regular vitamin D supplements to become part of the treatment armamentarium for patients with systemic lupus erythematosus after finding low levels of the vitamin were linked to end-stage renal disease and total organ damage.

Dr. Michelle Petri from the department of rheumatology at Johns Hopkins University, Baltimore, said that supplementary vitamin D was safe, helped to prevent one of the most dreaded complications of SLE, and likely has a role in preventing blood clots and cardiovascular disease.

“Vitamin D supplementation, which can reduce proteinuria, should be a part of the treatment plan for lupus nephritis patients,” she said.

Dr Petri and colleagues analysed 1,392 patients with SLE participating in the Hopkins Lupus Cohort. The risk of lifetime organ damage was assessed using the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index.

Results showed that after adjusting for age, gender, and ethnicity, low levels of vitamin D were significantly associated with increased risk of renal damage ( RR, 1.66; P = 0.0206) and total organ damage (RR, 1.17; P = 0.0245)  (see table 1).

“A lot of vitamins have come and gone and they haven’t lived up to their reputation and science has proven that they didn’t have benefit but I think vitamin D is here to stay, both in the general population and in people with systemic lupus erythematosus,”  Dr Petri said.

 

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

 

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