ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1709491
This article is part of the Research TopicNutritional Status and Nutritional Support in Hospitalized PatientsView all 10 articles
Vitamin D Deficiency and Risk of Acute Kidney Injury After Ischemic Stroke: A Propensity-Matched Cohort Study
Provisionally accepted
- 1Chi Mei Medical Center, Tainan, Taiwan
- 2E-Da Hospital, Yanchao District, Taiwan
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Background: Vitamin D deficiency (VDD) has been linked to adverse outcomes in various clinical settings, but its relationship with post-stroke acute kidney injury (AKI) remains unexplored. Methods: This retrospective cohort study utilized the TriNetX research network database to identify adult patients with first-documented ischemic stroke between January 2010 and December 2024. Patients were stratified based on serum 25-hydroxyvitamin D levels measured within six weeks pre-stroke: VDD group (<20 ng/mL) and control group (≥30 ng/mL). After 1:1 propensity score matching, we compared 30-day and 1-12 month outcomes between groups, with the primary outcome being AKI incidence within 30 days post-stroke. Results: After matching (n = 4,343 per group), patients with pre-stroke VDD demonstrated significantly higher 30-day AKI incidence compared with those with sufficient vitamin D levels (5.3% vs 3.5%; odds ratio [OR] = 1.55, 95% confidence interval [CI] 1.26–1.92; p < 0.001). VDD was also associated with increased risks of all-cause mortality (OR = 1.63, 95% CI 1.26–2.12), intensive care unit (ICU) admission (OR = 1.55, 95% CI 1.30–1.84), pneumonia (OR = 1.48, 95% CI 1.09–2.02), and dialysis requirement (OR = 2.33, 95% CI 1.36–4.00). Vitamin D insufficiency (20–29 ng/mL) was associated with a milder but significant AKI risk increase (OR = 1.39, 95% CI 1.12–1.72; p = 0.003). The adverse effect of VDD persisted during 1–12 month follow-up, with higher risks of AKI (hazard ratio [HR] = 1.32, 95% CI 1.13–1.55) and progression to end-stage renal disease (HR = 1.69, 95% CI 1.16–2.46). Conclusions: Pre-stroke VDD is associated with increased risk of post-stroke AKI and other adverse outcomes. The observed dose-dependent relationship suggests potential benefits from optimizing vitamin D status. These findings highlight the importance of assessing vitamin D levels in stroke risk stratification and suggest potential preventive strategies.
Keywords: Vitamin D Deficiency, Acute Kidney Injury, ischemic stroke, Retrospective study, Propensity score matching
Received: 20 Sep 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Hung, Chang, Lai, Yew, Liu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: I-Wen Chen, cheniwena60912@gmail.com
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