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Prevalence of 25(OH) vitamin D insufficiency and deficiency in chronic kidney disease stage 5 patients on hemodialysis.
Hemodial Int. 2007 Jul; 11(3):315-21.HI

Abstract

Little is known about the magnitude of vitamin D deficiency in patients with stage 5 chronic kidney disease (CKD-5) on hemodialysis (HD). In the present study, we examined the prevalence of vitamin D deficiency in patients with CKD-5 undergoing HD, evaluating the relationship between calcidiol levels with other parameters of mineral metabolism, nutrition/inflammation, functional capacity (FC), and sunlight exposure. Serum 25(OH) vitamin D levels were evaluated in 84 stable patients on chronic HD not receiving vitamin D supplements, with a mean age 58.9+/-16.6 years, during the month of September (end of winter in the southern hemisphere). 25(OH) vitamin D serum levels, intact PTH (iPTH), as well as serum albumin, calcium, phosphorus, and alkaline phosphatase were analyzed in fasting samples. Similarly, protein catabolic rate (PCR) and body mass index (BMI) were determined as nutritional parameters. Functional capacity according to the Karnofsky index, and sunlight exposure were also analyzed. In this study, we considered adequate vitamin D levels those above 30 ng/mL (U.S.A. National Kidney Foundation DOQI Guidelines), vitamin D insufficiency when levels were between 15 and 30 ng/mL, and vitamin D deficiency when levels were below 15 ng/mL. The mean 25(OH) D levels were significantly higher in men than in women (28.6 vs. 18.9 ng/mL; p=0.001). Vitamin D insufficiency was found in 53.5% of the patients (n=45) and vitamin D deficiency in 22.6% (n=19). In the univariate analysis, there were no correlations between 25(OH) D levels with age, iPTH, calcium, or phosphorus. There were positive correlations between serum 25(OH) D levels and degrees of sunlight exposure (R=0.55; p<0.0001), serum creatinine (r=0.38; p<0.001), serum albumin (r=0.22; p=0.04), and a negative correlation with BMI (r=-0.26; p=0.01). In the multiple regression analysis, only sunlight exposure (B=0.361), BMI (B=-0.23), and gender (B=-0.27) were significantly associated with 25(OH) D levels. Patients with FC 1 to FC 2 (n: 70%, 83.3%) had significantly higher 25(OH) D serum levels compared with FC 3 to FC 4 patients (n: 14%, 16.6%): 25.9 vs. 17.1 ng/mL (p=0.03). These results indicate that vitamin D insufficiency/deficiency is highly prevalent (76.1%) at the end of winter, in stage 5 CKD patients on HD, and lower values seem to be related to decreased sunlight exposure, female gender, increased BMI, and worse functional class.

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Authors+Show Affiliations

Del Valle E
Fresenius Medical Care, Quilmes, Argentina.
Negri AL
No affiliation info available
Aguirre C
No affiliation info available
Fradinger E
No affiliation info available
Zanchetta JR
No affiliation info available

MeSH

AdultAgedBody Mass IndexCalcifediolFastingFemaleHumansMaleMiddle AgedMineralsPractice Guidelines as TopicPrevalenceRenal DialysisRenal Insufficiency, ChronicSeasonsSeverity of Illness IndexSex FactorsSunlightVitamin D Deficiency

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

17576296

Clinical Trial Links

Effect of Vitamin D Supplementation on Erythropoietin Dosage in Hemodialysis Patients Who Have Vitamin D Deficiency

Citation

Del Valle, Elisa, et al. "Prevalence of 25(OH) Vitamin D Insufficiency and Deficiency in Chronic Kidney Disease Stage 5 Patients On Hemodialysis." Hemodialysis International. International Symposium On Home Hemodialysis, vol. 11, no. 3, 2007, pp. 315-21.
Del Valle E, Negri AL, Aguirre C, et al. Prevalence of 25(OH) vitamin D insufficiency and deficiency in chronic kidney disease stage 5 patients on hemodialysis. Hemodial Int. 2007;11(3):315-21.
Del Valle, E., Negri, A. L., Aguirre, C., Fradinger, E., & Zanchetta, J. R. (2007). Prevalence of 25(OH) vitamin D insufficiency and deficiency in chronic kidney disease stage 5 patients on hemodialysis. Hemodialysis International. International Symposium On Home Hemodialysis, 11(3), 315-21.
Del Valle E, et al. Prevalence of 25(OH) Vitamin D Insufficiency and Deficiency in Chronic Kidney Disease Stage 5 Patients On Hemodialysis. Hemodial Int. 2007;11(3):315-21. PubMed PMID: 17576296.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of 25(OH) vitamin D insufficiency and deficiency in chronic kidney disease stage 5 patients on hemodialysis. AU - Del Valle,Elisa, AU - Negri,Armando L, AU - Aguirre,Cristina, AU - Fradinger,Erich, AU - Zanchetta,Jose R, PY - 2007/6/20/pubmed PY - 2007/12/28/medline PY - 2007/6/20/entrez SP - 315 EP - 21 JF - Hemodialysis international. International Symposium on Home Hemodialysis JO - Hemodial Int VL - 11 IS - 3 N2 - Little is known about the magnitude of vitamin D deficiency in patients with stage 5 chronic kidney disease (CKD-5) on hemodialysis (HD). In the present study, we examined the prevalence of vitamin D deficiency in patients with CKD-5 undergoing HD, evaluating the relationship between calcidiol levels with other parameters of mineral metabolism, nutrition/inflammation, functional capacity (FC), and sunlight exposure. Serum 25(OH) vitamin D levels were evaluated in 84 stable patients on chronic HD not receiving vitamin D supplements, with a mean age 58.9+/-16.6 years, during the month of September (end of winter in the southern hemisphere). 25(OH) vitamin D serum levels, intact PTH (iPTH), as well as serum albumin, calcium, phosphorus, and alkaline phosphatase were analyzed in fasting samples. Similarly, protein catabolic rate (PCR) and body mass index (BMI) were determined as nutritional parameters. Functional capacity according to the Karnofsky index, and sunlight exposure were also analyzed. In this study, we considered adequate vitamin D levels those above 30 ng/mL (U.S.A. National Kidney Foundation DOQI Guidelines), vitamin D insufficiency when levels were between 15 and 30 ng/mL, and vitamin D deficiency when levels were below 15 ng/mL. The mean 25(OH) D levels were significantly higher in men than in women (28.6 vs. 18.9 ng/mL; p=0.001). Vitamin D insufficiency was found in 53.5% of the patients (n=45) and vitamin D deficiency in 22.6% (n=19). In the univariate analysis, there were no correlations between 25(OH) D levels with age, iPTH, calcium, or phosphorus. There were positive correlations between serum 25(OH) D levels and degrees of sunlight exposure (R=0.55; p<0.0001), serum creatinine (r=0.38; p<0.001), serum albumin (r=0.22; p=0.04), and a negative correlation with BMI (r=-0.26; p=0.01). In the multiple regression analysis, only sunlight exposure (B=0.361), BMI (B=-0.23), and gender (B=-0.27) were significantly associated with 25(OH) D levels. Patients with FC 1 to FC 2 (n: 70%, 83.3%) had significantly higher 25(OH) D serum levels compared with FC 3 to FC 4 patients (n: 14%, 16.6%): 25.9 vs. 17.1 ng/mL (p=0.03). These results indicate that vitamin D insufficiency/deficiency is highly prevalent (76.1%) at the end of winter, in stage 5 CKD patients on HD, and lower values seem to be related to decreased sunlight exposure, female gender, increased BMI, and worse functional class. SN - 1492-7535 UR - https://www.unboundmedicine.com/medline/citation/17576296/Prevalence_of_25_OH__vitamin_D_insufficiency_and_deficiency_in_chronic_kidney_disease_stage_5_patients_on_hemodialysis_ L2 - https://doi.org/10.1111/j.1542-4758.2007.00186.x DB - PRIME DP - Unbound Medicine ER -