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Vitamin D deficiency and insufficiency in patients with chronic kidney disease.
J Bras Nefrol. 2012 Mar; 34(1):58-63.JB

Abstract

INTRODUCTION

Vitamin D deficiency is common among patients with chronic kidney disease (CKD). A higher level of serum vitamin D is expected in residents of the tropics in relation to inhabitants of non-tropical regions, due to greater sun exposure and increased production of vitamin D.

OBJECTIVE

To analyze serum levels of vitamin D, such as 25-hydroxyvitamin D - 25(OH)D, in Brazilian patients at the predialytic stage with CKD.

METHODS

We studied 125 patients (aged 57.4 ± 16.2 years, 78 were white and 55.2%, male), with creatinine 2.67 ± 1.73 mg/dL and creatinine clearance 43.7 ± 34.5 mL/min. Body mass index was 27.4 ± 4.7 kg/m², and waist circumference was 95.0 ± 14.0 cm. Calcium was 9.3 ± 0.6 mg/dL, intact parathormone (iPTH) 212.6 ± 221.2 pg/mL and serum albumin 4.2 ± 0.6 g/dL. The mean 25(OH)D was 23.9 ± 10.7 ng/mL.

RESULTS

Out of the 125 patients, we found that 92 (72.6%) had suboptimal levels of 25(OH)D < 30 ng/mL, and 65 (52%) had vitamin D insufficiency (15-29 ng/mL); 27 (21.5%) had deficiency (5-14 ng/mL) and only one patient had severe vitamin D deficiency <5 ng/mL. No differences were observed among the levels of 25 (H)D in stratified patients as to the CKD stage. Levels of 25(OH)D were higher among males (38.1 ± 20.6 versus 22.4 ± 9.7 ng/mL; p < 0.0001), and there was an inverse correlation between levels 25(OH)D and iPTH, proteinuria and abdominal circumference, and a positive correlation between 25(OH)D and calcium and serum albumin. Multivariate analysis only showed inverse correlation between serum 25(OH)D and iPTH and abdominal circumference.

CONCLUSION

Even though the Brazilian population live in a tropical region, most patients had suboptimal levels of serum vitamin D, and this pattern may play a role in the development of hyperparathyroidism.

Authors+Show Affiliations

Nefrology Service at Hospital das Clínicas at the Medical School of Universidade de São Paulo – FMUSP.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng por

PubMed ID

22441183

Citation

Diniz, Herculano Ferreira, et al. "Vitamin D Deficiency and Insufficiency in Patients With Chronic Kidney Disease." Jornal Brasileiro De Nefrologia : 'orgao Oficial De Sociedades Brasileira E Latino-Americana De Nefrologia, vol. 34, no. 1, 2012, pp. 58-63.
Diniz HF, Romão MF, Elias RM, et al. Vitamin D deficiency and insufficiency in patients with chronic kidney disease. J Bras Nefrol. 2012;34(1):58-63.
Diniz, H. F., Romão, M. F., Elias, R. M., & Romão Júnior, J. E. (2012). Vitamin D deficiency and insufficiency in patients with chronic kidney disease. Jornal Brasileiro De Nefrologia : 'orgao Oficial De Sociedades Brasileira E Latino-Americana De Nefrologia, 34(1), 58-63.
Diniz HF, et al. Vitamin D Deficiency and Insufficiency in Patients With Chronic Kidney Disease. J Bras Nefrol. 2012;34(1):58-63. PubMed PMID: 22441183.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D deficiency and insufficiency in patients with chronic kidney disease. AU - Diniz,Herculano Ferreira, AU - Romão,Mariana Fadil, AU - Elias,Rosilene Motta, AU - Romão Júnior,João Egídio, PY - 2011/09/30/received PY - 2011/11/16/accepted PY - 2012/3/24/entrez PY - 2012/3/24/pubmed PY - 2012/8/3/medline SP - 58 EP - 63 JF - Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia JO - J Bras Nefrol VL - 34 IS - 1 N2 - INTRODUCTION: Vitamin D deficiency is common among patients with chronic kidney disease (CKD). A higher level of serum vitamin D is expected in residents of the tropics in relation to inhabitants of non-tropical regions, due to greater sun exposure and increased production of vitamin D. OBJECTIVE: To analyze serum levels of vitamin D, such as 25-hydroxyvitamin D - 25(OH)D, in Brazilian patients at the predialytic stage with CKD. METHODS: We studied 125 patients (aged 57.4 ± 16.2 years, 78 were white and 55.2%, male), with creatinine 2.67 ± 1.73 mg/dL and creatinine clearance 43.7 ± 34.5 mL/min. Body mass index was 27.4 ± 4.7 kg/m², and waist circumference was 95.0 ± 14.0 cm. Calcium was 9.3 ± 0.6 mg/dL, intact parathormone (iPTH) 212.6 ± 221.2 pg/mL and serum albumin 4.2 ± 0.6 g/dL. The mean 25(OH)D was 23.9 ± 10.7 ng/mL. RESULTS: Out of the 125 patients, we found that 92 (72.6%) had suboptimal levels of 25(OH)D < 30 ng/mL, and 65 (52%) had vitamin D insufficiency (15-29 ng/mL); 27 (21.5%) had deficiency (5-14 ng/mL) and only one patient had severe vitamin D deficiency <5 ng/mL. No differences were observed among the levels of 25 (H)D in stratified patients as to the CKD stage. Levels of 25(OH)D were higher among males (38.1 ± 20.6 versus 22.4 ± 9.7 ng/mL; p < 0.0001), and there was an inverse correlation between levels 25(OH)D and iPTH, proteinuria and abdominal circumference, and a positive correlation between 25(OH)D and calcium and serum albumin. Multivariate analysis only showed inverse correlation between serum 25(OH)D and iPTH and abdominal circumference. CONCLUSION: Even though the Brazilian population live in a tropical region, most patients had suboptimal levels of serum vitamin D, and this pattern may play a role in the development of hyperparathyroidism. SN - 2175-8239 UR - https://www.unboundmedicine.com/medline/citation/22441183/Vitamin_D_deficiency_and_insufficiency_in_patients_with_chronic_kidney_disease_ L2 - https://www.scielo.br/scielo.php?script=sci_arttext&amp;pid=S0101-28002012000100009&amp;lng=en&amp;nrm=iso&amp;tlng=en DB - PRIME DP - Unbound Medicine ER -