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Vitamin D status of chronic kidney disease patients living in a sunny country.

Abstract

BACKGROUND

Vitamin D nutritional status has been poorly investigated in chronic kidney disease (CKD) patients, especially those inhabiting a subtropical area where the sunlight incidence is abundant all year.

OBJECTIVE

The purpose of this study was to evaluate the status of vitamin D and to analyze the relationship of circulating 25-hydroxyvitamin D [25(OH)D] with other serum parameters of mineral metabolism in patients with CKD not yet on dialysis.

DESIGN

This cross-sectional study enrolled 144 nondiabetic CKD patients not yet receiving dialysis (stages 2 to 5 of CKD). Fasting blood samples were obtained for measurements of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)(2)D], intact parathyroid hormone, phosphorus, and calcium.

RESULTS

In the entire sample, the serum concentration of 25(OH) was 34.3 +/- 18.3 ng/mL (+/-SD unless otherwise noted). A deficiency of vitamin D, i.e., 25(OH)D <15 ng/mL, was found in only one patient. Fifty-seven patients (39.6%) were considered vitamin D-insufficient (16 to 30 ng/mL). The vitamin D-insufficient group contained more females, a higher degree of proteinuria, and a lower serum concentration of 1,25(OH)(2)D. In multiple regression analysis, 25(OH)D was associated positively with 1,25(OH)(2)D, serum calcium, and proteinuria, whereas 1,25(OH)(2)D was associated only with 25(OH)D and phosphorus. The variables associated with intact parathormone were serum phosphorus and creatinine clearance, but not 1,25(OH)(2)D or 25(OH)D.

CONCLUSION

Despite an elevated prevalence of vitamin D insufficiency, the serum concentration of 25(OH)D was, on average, higher than that found in patients inhabiting higher-latitude regions. This higher serum concentration may have contributed to the differences found in the relationship between vitamin D metabolites and other serum markers of mineral metabolism in our CKD patients.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil. lilian@dis.epm.br

    ,

    Source

    MeSH

    Aged
    Calcifediol
    Calcium
    Creatinine
    Cross-Sectional Studies
    Female
    Humans
    Kidney Failure, Chronic
    Male
    Metabolic Clearance Rate
    Middle Aged
    Minerals
    Nutritional Status
    Phosphorus
    Proteinuria
    Sex Factors
    Sunlight
    Vitamin D
    Vitamin D Deficiency

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18721735

    Citation

    Cuppari, Lilian, et al. "Vitamin D Status of Chronic Kidney Disease Patients Living in a Sunny Country." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 18, no. 5, 2008, pp. 408-14.
    Cuppari L, Carvalho AB, Draibe SA. Vitamin D status of chronic kidney disease patients living in a sunny country. J Ren Nutr. 2008;18(5):408-14.
    Cuppari, L., Carvalho, A. B., & Draibe, S. A. (2008). Vitamin D status of chronic kidney disease patients living in a sunny country. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 18(5), pp. 408-14. doi:10.1053/j.jrn.2008.05.004.
    Cuppari L, Carvalho AB, Draibe SA. Vitamin D Status of Chronic Kidney Disease Patients Living in a Sunny Country. J Ren Nutr. 2008;18(5):408-14. PubMed PMID: 18721735.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamin D status of chronic kidney disease patients living in a sunny country. AU - Cuppari,Lilian, AU - Carvalho,Aluízio B, AU - Draibe,Sérgio A, PY - 2007/10/03/received PY - 2008/8/30/pubmed PY - 2008/12/18/medline PY - 2008/8/30/entrez SP - 408 EP - 14 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 18 IS - 5 N2 - BACKGROUND: Vitamin D nutritional status has been poorly investigated in chronic kidney disease (CKD) patients, especially those inhabiting a subtropical area where the sunlight incidence is abundant all year. OBJECTIVE: The purpose of this study was to evaluate the status of vitamin D and to analyze the relationship of circulating 25-hydroxyvitamin D [25(OH)D] with other serum parameters of mineral metabolism in patients with CKD not yet on dialysis. DESIGN: This cross-sectional study enrolled 144 nondiabetic CKD patients not yet receiving dialysis (stages 2 to 5 of CKD). Fasting blood samples were obtained for measurements of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)(2)D], intact parathyroid hormone, phosphorus, and calcium. RESULTS: In the entire sample, the serum concentration of 25(OH) was 34.3 +/- 18.3 ng/mL (+/-SD unless otherwise noted). A deficiency of vitamin D, i.e., 25(OH)D <15 ng/mL, was found in only one patient. Fifty-seven patients (39.6%) were considered vitamin D-insufficient (16 to 30 ng/mL). The vitamin D-insufficient group contained more females, a higher degree of proteinuria, and a lower serum concentration of 1,25(OH)(2)D. In multiple regression analysis, 25(OH)D was associated positively with 1,25(OH)(2)D, serum calcium, and proteinuria, whereas 1,25(OH)(2)D was associated only with 25(OH)D and phosphorus. The variables associated with intact parathormone were serum phosphorus and creatinine clearance, but not 1,25(OH)(2)D or 25(OH)D. CONCLUSION: Despite an elevated prevalence of vitamin D insufficiency, the serum concentration of 25(OH)D was, on average, higher than that found in patients inhabiting higher-latitude regions. This higher serum concentration may have contributed to the differences found in the relationship between vitamin D metabolites and other serum markers of mineral metabolism in our CKD patients. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/18721735/Vitamin_D_status_of_chronic_kidney_disease_patients_living_in_a_sunny_country_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(08)00336-1 DB - PRIME DP - Unbound Medicine ER -