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Vitamin D deficiency in hemodialysis patients.

Bansal B, Bansal S, Mithal A, Kher V, Marwaha R - Indian J Endocrinol Metab (2012)

Bottom Line: Vitamin D [(25(OH)D] deficiency and insufficiency is common in patients with chronic kidney disease (CKD). 25(OH)D has been found to have beneficial effects on bone, cardiovascular and immune functions.There was a weak correlation between 25(OH)D levels and weight, sex, hemoglobin, albumin, alkaline phosphatase, and presence of diabetes.There was, however, no correlation with duration of dialysis or PTH levels.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Diabetes, Medanta, the Medicity, Gurgaon, India.

ABSTRACT

Background: Vitamin D [(25(OH)D] deficiency and insufficiency is common in patients with chronic kidney disease (CKD). 25(OH)D has been found to have beneficial effects on bone, cardiovascular and immune functions. There are little data about vitamin D levels in Indian patients on dialysis. This study was undertaken to determine the vitamin D status of Indian CKD patients on hemodialysis.

Materials and methods: We included 45 patients on maintenance hemodialysis coming to Medanta, Medicity, Gurgaon. 25(OH)D levels were measured with radioimmunoassay (Diasorin) method and parathyroid hormone (PTH) was measured using electrochemiluminiscence immunoassay (ECLIA).

Results: The mean age of patients was 55 ± 13 years. 32/45 (71%) were males. 23/45 (51%) were diabetics. The median duration of hemodialysis was 5.5 months (range 1-74 months). 33/45 (74%) patients were on thrice weekly hemodialysis. The mean level of vitamin D was 10.14 ± 8.7 ng/ml. Majority of the patients [43/45 (95.5%)] were either vitamin D deficient or had insufficient levels. 40/45 (88.9%) were vitamin D deficient (levels <20 ng/ml); of these, 29/40 (64.4%) had severe vitamin D deficiency (levels <10 ng/ml) and 3/45 (6.7%) had insufficient levels (20-30 ng/ml) of vitamin D. Only 2/45 (4.4%) patients had normal levels of vitamin D. 23/45 (51%) of patients were receiving calcitriol. The mean levels of serum calcium, phosphorus, alkaline phosphatase, and albumin were 8.8 ± 0.64 mg/dl, 5.0 ± 0.7 mg/dl, 126 ± 10.3 IU/l and 3.6 ± 0.62 g/dl, respectively. PTH levels ranged from 37 to 1066 pg/ml, and the median was 195.8 pg/ml. There was a weak correlation between 25(OH)D levels and weight, sex, hemoglobin, albumin, alkaline phosphatase, and presence of diabetes. There was, however, no correlation with duration of dialysis or PTH levels.

Conclusion: Vitamin D deficiency and insufficiency are universal in our hemodialysis patients, with severe vitamin D deficiency in two-third of patients.

No MeSH data available.


Related in: MedlinePlus

Distribution of 25(OH)D levels
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Figure 1: Distribution of 25(OH)D levels

Mentions: Mean 25(OH)D level was 10.14 ± 8.7 ng/ml. Only 2 (4.4%) patients were vitamin D sufficient and 3 (6.7%) were vitamin D insufficient. The remaining 40 (88.9%) were vitamin D deficient [Table 2 and Figure 1]. Of these, 29 (64.4%) had severe vitamin D deficiency with 25(OH)D less than 10 ng/ml. Majority of these patients were on usual calcium supplements and 23/45 (51%) patients were on calcitriol. PTH levels ranged from 37 to 1066 pg/ml and the median was 195.8 pg/ml.


Vitamin D deficiency in hemodialysis patients.

Bansal B, Bansal S, Mithal A, Kher V, Marwaha R - Indian J Endocrinol Metab (2012)

Distribution of 25(OH)D levels
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3313747&req=5

Figure 1: Distribution of 25(OH)D levels
Mentions: Mean 25(OH)D level was 10.14 ± 8.7 ng/ml. Only 2 (4.4%) patients were vitamin D sufficient and 3 (6.7%) were vitamin D insufficient. The remaining 40 (88.9%) were vitamin D deficient [Table 2 and Figure 1]. Of these, 29 (64.4%) had severe vitamin D deficiency with 25(OH)D less than 10 ng/ml. Majority of these patients were on usual calcium supplements and 23/45 (51%) patients were on calcitriol. PTH levels ranged from 37 to 1066 pg/ml and the median was 195.8 pg/ml.

Bottom Line: Vitamin D [(25(OH)D] deficiency and insufficiency is common in patients with chronic kidney disease (CKD). 25(OH)D has been found to have beneficial effects on bone, cardiovascular and immune functions.There was a weak correlation between 25(OH)D levels and weight, sex, hemoglobin, albumin, alkaline phosphatase, and presence of diabetes.There was, however, no correlation with duration of dialysis or PTH levels.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Diabetes, Medanta, the Medicity, Gurgaon, India.

ABSTRACT

Background: Vitamin D [(25(OH)D] deficiency and insufficiency is common in patients with chronic kidney disease (CKD). 25(OH)D has been found to have beneficial effects on bone, cardiovascular and immune functions. There are little data about vitamin D levels in Indian patients on dialysis. This study was undertaken to determine the vitamin D status of Indian CKD patients on hemodialysis.

Materials and methods: We included 45 patients on maintenance hemodialysis coming to Medanta, Medicity, Gurgaon. 25(OH)D levels were measured with radioimmunoassay (Diasorin) method and parathyroid hormone (PTH) was measured using electrochemiluminiscence immunoassay (ECLIA).

Results: The mean age of patients was 55 ± 13 years. 32/45 (71%) were males. 23/45 (51%) were diabetics. The median duration of hemodialysis was 5.5 months (range 1-74 months). 33/45 (74%) patients were on thrice weekly hemodialysis. The mean level of vitamin D was 10.14 ± 8.7 ng/ml. Majority of the patients [43/45 (95.5%)] were either vitamin D deficient or had insufficient levels. 40/45 (88.9%) were vitamin D deficient (levels <20 ng/ml); of these, 29/40 (64.4%) had severe vitamin D deficiency (levels <10 ng/ml) and 3/45 (6.7%) had insufficient levels (20-30 ng/ml) of vitamin D. Only 2/45 (4.4%) patients had normal levels of vitamin D. 23/45 (51%) of patients were receiving calcitriol. The mean levels of serum calcium, phosphorus, alkaline phosphatase, and albumin were 8.8 ± 0.64 mg/dl, 5.0 ± 0.7 mg/dl, 126 ± 10.3 IU/l and 3.6 ± 0.62 g/dl, respectively. PTH levels ranged from 37 to 1066 pg/ml, and the median was 195.8 pg/ml. There was a weak correlation between 25(OH)D levels and weight, sex, hemoglobin, albumin, alkaline phosphatase, and presence of diabetes. There was, however, no correlation with duration of dialysis or PTH levels.

Conclusion: Vitamin D deficiency and insufficiency are universal in our hemodialysis patients, with severe vitamin D deficiency in two-third of patients.

No MeSH data available.


Related in: MedlinePlus