The Kidney Foundation of Canada

2018 Allied Health Research Grant recipients

Dr. Diana Mager 

University of Alberta, AB

Vitamin D and frailty: longitudinal assessment of risk factors in adults with diabetes and chronic kidney disease

Co-applicant: Peter A Senior

2018-2020:  $99,889 | Allied Health Research Grant |  Category: Diabetes

Lay Summary

One of the most common problems in people with kidney disease is the high frequency of having several coinciding medical conditions such as osteoporosis and frailty leading to bone fractures, falls, lifelong health problems and reduced health related quality of life (HRQOL). Frailty in particular is very common in adults with chronic kidney disease and it can result in significant muscle weakness, which can in turn result in increasing difficulties performing daily activities such as walking.

One of the factors that are thought to contribute to an increased risk for frailty is suboptimal vitamin D (vitD) status. VitD deficiency is very common in Canada (especially in northern Alberta) because winter is very long. Most people also don’t eat or drink enough foods that are high in VitD (like milk) and so they don’t have enough Vit D in their body to keep muscles strong. Although many people can feel their muscles are getting weaker because it’s harder to walk or climb stairs, they are not sure of the best course of action or whether vitD can help. Right now, we are not sure exactly how much Vit D people with diabetes and kidney disease need to take to prevent them from developing weak muscles (frailty). This is important to understand as frailty can lead to an increased risk for falls and has been shown to also be associated with increasing hospital visits and reduced HRQOL. We recently showed that people with diabetes and kidney disease who take daily vitamin D pills over a 2-3-year time horizon have stable bone health. However, we also observed that some individuals over the same time period who did not take their vitamin D supplements every day reported increasing difficulties in their ability to perform activities of daily life, (such as walking and climbing stairs), experienced greater loss of muscle mass and more visits to the hospital than those who took their vitD supplements every day.

As we know that vitD is an important nutrient to ensure muscles stay strong and work well, we want to study all of the people we originally studied for an additional three years. Our plan is to measure vitD levels in the blood, and to measure muscle strength/muscle mass, ability to perform activities of daily life (walking, climbing stress, etc.) and HRQOL on a yearly basis for another three years in these same people so we can understand if taking vitamin D supplements can help prevent frailty. This information will help us to understand the best way to prevent frailty over the long term in patients with diabetes and chronic kidney disease.