25-Hydroxyvitamin D levels and albuminuria in the Third National Health and Nutrition Examination Survey (NHANES III)

Am J Kidney Dis. 2007 Jul;50(1):69-77. doi: 10.1053/j.ajkd.2007.04.015.


Background: Albuminuria is a risk factor for chronic kidney disease progression, end-stage renal disease, cardiovascular events, and mortality. Animal studies suggested that vitamin D insufficiency may contribute to the pathogenesis of albuminuria.

Study design: Cross-sectional study.

Setting & participants: 15,068 adults participating in the Third National Health and Nutrition Examination Survey.

Predictor: Serum 25-hydroxyvitamin D concentration, examined in quartiles.

Outcomes & measurements: Albuminuria, defined using established sex-specific cutoff values for urine albumin-creatinine ratio (25 to 2,999 mg/g for women, 17 to 2,999 mg/g for men).

Results: A stepwise increase in the prevalence of albuminuria was observed with decreasing quartiles of vitamin D concentration: 8.9%, 11.5%, 13.7%, and 15.8% (P < 0.001). Adjusting for age, sex, race/ethnicity, region and season of measurement, smoking status, body mass index, and estimated glomerular filtration rate, relative risks for albuminuria by decreasing quartile of vitamin D concentration were 1.00 (reference group), 1.14 (95% confidence interval, 0.95 to 1.37), 1.22 (95% confidence interval, 1.03 to 1.45), and 1.37 (95% confidence interval, 1.10 to 1.71; P = 0.006). Additionally adjusting for blood pressure and diabetes mellitus, these risks were somewhat attenuated and retained statistical significance.

Limitations: The cross-sectional design of this study does not allow demonstration of temporal or causal relationships between vitamin D and albuminuria.

Conclusions: Additional studies are needed to clarify the relationship of vitamin D with albuminuria and determine whether vitamin D therapy prevents or improves markers of kidney and cardiovascular disease.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Albuminuria / complications
  • Albuminuria / epidemiology*
  • Albuminuria / ethnology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Kidney Failure, Chronic
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Prevalence
  • Reference Values
  • Seasons
  • United States / epidemiology
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / epidemiology*


  • Vitamin D
  • 25-hydroxyvitamin D