scholarly journals Vitamin D Binding Protein Is Not Involved in Vitamin D Deficiency in Patients with Chronic Kidney Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Marta Kalousova ◽  
Sylvie Dusilova-Sulkova ◽  
Oskar Zakiyanov ◽  
Milada Kostirova ◽  
Roman Safranek ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin D Deficiency ◽  
Binding Protein ◽  
Plasma Vitamin ◽  
Separate Determination ◽  
Vitamin D Binding Protein ◽  
Enhanced Production ◽  
Vitamin D Levels

Objective. This study was designed to evaluate vitamin D status with separate determination of 25-OH D2and 25-OH D3and its relationship to vitamin D binding protein (VDBP) in patients with chronic kidney disease (CKD) and long-term haemodialysis patients (HD).Methods. 45 CKD patients, 103 HD patients, and 25 controls (C) were included. Plasma vitamin D concentrations were determined using chromatography and VDBP in serum and urine in CKD using enzyme immunoassay.Results. Plasma vitamin D levels were lower in CKD (30.16 ± 16.74 ng/mL) and HD (18.85 ± 15.85 ng/mL) versus C (48.72 ± 18.35 ng/mL),P<0.0001. 25-OH D3was the dominant form of vitamin D. Serum VDBP was higher in CKD (273.2 ± 93.8 ug/mL) versus C (222 ± 87.6 ug/mL) and HD (213.8 ± 70.9 ug/mL),P=0.0003. Vitamin D/VDBP ratio was the highest in C and the lowest in HD; however, there was no correlation between vitamin D and VDBP. Urinary concentration of VDBP in CKD (0.25 ± 0.13 ug/mL) correlated with proteinuria(r=0.43,P=0.003).Conclusions. Plasma levels of vitamin D are decreased in CKD patients and especially in HD patients. 25-OH D3was the major form of vitamin D. Despite urinary losses of VDBP, CKD patients had higher serum VDBP concentrations, indicating compensatory enhanced production. Vitamin D binding protein is not involved in vitamin D deficiency.

scholarly journals Urinary Tamm-Horsfall protein, albumin, vitamin D-binding protein, and retinol-binding protein as early biomarkers of chronic kidney disease in dogs

2017 ◽  
Vol 5 (11) ◽  
pp. e13262 ◽  
Author(s):  
Fernanda Chacar ◽  
Márcia Kogika ◽  
Talita R. Sanches ◽  
Douglas Caragelasco ◽  
Cínthia Martorelli ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Binding Protein ◽  
Retinol Binding Protein ◽  
Vitamin D Binding Protein ◽  
Early Biomarkers

scholarly journals Prevalence of Decreased Vitamin D Levels is High among Veterans with Diabetes and/or CKD

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Subhashini Yaturu ◽  
Jared Davis
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin D Deficiency ◽  
Vitamin D Insufficiency ◽  
Record System ◽  
Vitamin D Levels ◽  
History Of ◽  
Computerized Patient Record ◽  
25 Oh Vitamin D

Objective. Vitamin D deficiency is associated with a variety of skeletal and extraskeletal problems. The aim of this study was to evaluate the prevalence of vitamin D deficiency among veterans in sunny Louisiana. Methods. Using the VA computerized patient record system, we searched for all 25 (OH) Vitamin D and 1, 25 (OH) vitamin D levels that were measured between 2007 and 2009. The information collected for each patient included age, body mass index, creatinine, history of diabetes and hypertension, and levels of vitamin D and PTH. We determined the number of individuals who were vitamin D insufficient and deficient. Results. Among 2990 studies evaluated, the mean concentration of 25 (OH) D was  ng/mL, and that of 1, 25 (OH) vitamin D was  ng/mL. Among them, only 695 subjects (23%) had normal values, while 889 (30%) had insufficiency, and 1405 (47%) had deficiency. Subjects with diabetes (1041) had significantly () lower levels (21 and 25 ng/mL) of both 25 (OH) and 1,25 (OH) vitamin D compared to subjects without diabetes (23 and 32 ng/mL). Similarly, subjects with chronic kidney disease (1128) had much lower vitamin D levels than subjects without CKD. Among subjects with diabetes, those with chronic kidney disease (512) had much lower levels of both 25 (OH) and 1,25 (OH) vitamin D than with those with normal creatinine levels. Conclusions. We conclude that vitamin D insufficiency and deficiency is highly prevalent in veterans, more so among subjects with diabetes and/or CKD.

scholarly journals Vitamin D deficiency is not associated with increased oxidative stress in chronic kidney disease pre-dialysis patients

2020 ◽  
Author(s):  
Andressa Keiko Matsumoto ◽  
Michael Maes ◽  
Ana Paula Michelin ◽  
Abel Esteves Soares ◽  
Laura de Oliveira Semeão ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin D Deficiency ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Vitamin D Levels

Abstract Introduction: The progressive decline in 25-hydroxyvitamin D [25(OH)D] in chronic kidney disease (CKD) limits the kidney ability of synthesizing the vitamin. Vitamin D deficiency as defined by KDIGO (25(OH)D <20 ng/mL) is prevalent in CKD patients and associated to oxidative stress (OS). We studied a possible association between vitamin D deficiency and OS in pre-dialysis patients. Methods: A cross-sectional study with 206 CKD patients was carried out. Laboratory tests for 25(OH)D, 1,25(OH)2D, inflammatory markers, and OS were added to routine tests including creatinine, albumin, calcium, phosphorus, alkaline phosphatase, iPTH, glucose, hemoglobin, uric acid, total cholesterol, LDL, HDL, and triglycerides. Results: Vitamin D deficiency was present in 55 CKD patients and normal vitamin D levels were seen in 149 patients. There was a significant association between vitamin D and estimated glomerular filtration rate (eGRF). Homocysteine levels were best predicted by eGRF, sex, and age; high sensitivity C-reactive protein (hsCRP) by staging and BMI; nitric oxide metabolites (NOx) were increased in late disease; leptin was influenced by BMI and higher in women than man; and adiponectin levels were higher in women. Conclusions: OS biomarkers were not correlated with vitamin D deficiency but increased NOx were seen in stages 4-5 CKD patients. Even though a relatively large number of CKD patients was included and a broad number of OS and inflammatory biomarkers were used in this studied we failed to find an association between vitamin D levels and eGRF. More studies are needed to evaluate the influence of vitamin D status in OS in pre-dialysis CKD patients.

scholarly journals MON-372 Treatment-Resistant Vitamin D Deficiency: Is It a Vitamin D Binding Protein Issue?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Sirisha Thambuluru ◽  
Imran Unal ◽  
Stuart Frank ◽  
Amy Warriner ◽  
Fernando Ovalle ◽  
...  
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Vitamin D Deficiency ◽  
Binding Protein ◽  
High Dose ◽  
Vitamin D Metabolites ◽  
Vitamin D Binding Protein ◽  
Treatment Resistant ◽  
Vitamin D Levels ◽  
25 Oh Vitamin D

Abstract Introduction Vitamin D is present in free and bound forms; the bound form is complexed mainly to vitamin D binding protein (DBP). Vitamin D levels are affected by age, pregnancy, liver disease, obesity, and DBP mutations. We report a patient with treatment-resistant vitamin D deficiency suggestive of a DBP with abnormal vitamin D binding. Clinical Case A 58-year-old Pakistani male with a history of hypertension, sleep apnea and hypogonadism presented to endocrine clinic with symptoms including fatigue, generalized muscle cramps, and joint pain. Evaluation of common causes of fatigue, such as anemia, thyroid dysfunction and adrenal insufficiency were ruled out with CBC, thyroid hormone levels and ACTH stimulation test results all within normal ranges. A 25-OH vitamin D level was profoundly low (4.2 ng/ml; normal 30-100), and a 1,25-OH vitamin D level was undetectable (&lt;8 pg/ml; normal 18-72), leading to a presumptive diagnosis of severe vitamin D deficiency. However, his calcium, phosphorus, alkaline phosphatase and kidney function were in the normal range. Furthermore, the absence of osteoporosis, fracture history, or kidney stones suggested adequate vitamin D action at target tissues; PTH levels were high-normal to minimally elevated, ranging 70-94 pg/ml (12-88pg/mL). Aggressive supplementation with vitamin D3 at 50,000 IU 3 times a week and 5,000 IU daily failed to normalize 25-OH vitamin D (ranged 4.6-10ng/ml; normal 30-100) and 1,25-OH vitamin D levels remained undetectable. Addition of calcitriol resulted in mild hypercalcemia and was discontinued. Malabsorption did not appear to be a contributing factor, as a negative tTG antibody (with normal IgA) excluded celiac disease. Vitamin D metabolites levels measured with mass spectrometry showed undetectable 25-OH vitamin D levels (D2 &lt;4 ng/ml, D3 &lt;2 ng/ml; total &lt;6ng/ml; normal 20-50) and 1,25-OH vitamin D levels (&lt;8 pg/ml). Urine N-telopeptide, 24-hour urine calcium (177mg; 100-240) and bone-specific alkaline phosphatase were all normal. Repeat testing over more than five years showed similar results. DBP levels of 269 ug/ml [104-477] excluded DBP deficiency. Clinical Lesson Vitamin D deficiency is increasingly part of routine testing in internal medicine and endocrinology clinics, as is repletion with high-dose vitamin D. However, in rare cases such as this, relying on 25-OH vitamin D levels can be misleading, and supplementation unnecessary or potentially harmful. Thus, treatment decisions should consider the full clinical context and further evaluation performed when warranted. This patient’s labs are suggestive of an abnormality in the DBP, supporting future examination using molecular testing.

scholarly journals PREVALENCE OF VITAMIN D DEFICIENCY INPRE-DIALYTIC CHRONIC KIDNEY DISEASE PATIENTS ATTENDING A TERTIARY CENTRE IN NORTH-EAST INDIA

2021 ◽  
Vol 9 (01) ◽  
pp. 758-763
Author(s):  
Sagar Kanta ◽  
◽  
Tridip Kumar Das ◽  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin D Deficiency ◽  
Indian Population ◽  
Kidney Diseases ◽  
Sun Exposure ◽  
Assay Method ◽  
North East ◽  
Vitamin D Levels

Introduction: Vitamin D deficiency has not only been associated with bone and muscular complications but also with cancer, cardiovascular diseases, infection, maternal and neonatal complications. There are many causes of vitamin D deficiency including socio-demographic factors, the timing of sun exposure, along with drugs, skin, liver, and kidney diseases. India is closer to the equator so is considered to have a lower risk of Vitamin D deficiency but it is not so, with many studies implicating deficiency even in the general population. There are no studies done on the north-eastern Indian population document on vitamin D levels in Chronic Kidney Disease (CKD) patients. Aim: To study the prevalence of Vitamin D deficiency in the pre-dialytic chronic kidney disease. Material and Methods:Observational study was done. 120 CKD patients were included in the study and staging was done according to the MDRD formula. Total 25-OH Vitamin D was measured by the Enzyme Immuno Assay method. Results: 43.33% of the patients in the group were found to have vitamin D deficiency and 26.66% of patients had vitamin D insufficiency. There was a significant association between vitamin D deficiency and stages 4 and 5 CKD. There was not any significant correlation between vitamin D levels with age, sex, body mass index, serum calcium, or albumin. Conclusion:High levels of vitamin D deficiency were seen in the CKD patients of the northeast Indian population. There were statistically significant changes in vitamin D levels and stages 4 and 5 of CKD.

scholarly journals Very Low Vitamin D in a Patient with a Novel Pathogenic Variant in the GC Gene that encodes Vitamin D-Binding Protein

2021 ◽  
Author(s):  
Ronadip R Banerjee ◽  
Tara Spence ◽  
Stuart J Frank ◽  
Raj Pandian ◽  
Andrew N Hoofnagle ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gene Deletion ◽  
Binding Protein ◽  
Pathogenic Variant ◽  
Plasma Vitamin ◽  
Vitamin D Metabolites ◽  
Vitamin D Binding Protein ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
Gc Gene

Abstract Circulating plasma vitamin D metabolites are highly bound to vitamin D-binding protein (DBP), also known as group-specific component or Gc-globulin. DBP, encoded by the GC gene, is a member of the albumin family of globular serum transport proteins. We previously described a homozygous GC gene deletion in a patient with apparent severe vitamin D deficiency, fragility fractures and ankylosing spondylitis. Here, we report an unrelated patient free of fractures or rheumatologic disease, but with very low 25-hydroxyvitamin D and 1,25-hydroxyvitamin D, as well as undetectable DBP measured by liquid chromatography-tandem mass spectrometry. A whole gene deletion was excluded by microarray, and Sanger sequencing of GC revealed a homozygous pathogenic variant affecting a canonical splice site (c.702-1G&gt;A). These findings indicate that loss of function variants in GC that eliminate DBP, and severely reduced total circulating vitamin D levels, do not necessarily result in significant metabolic bone disease. Together with our previous report, these cases support the free-hormone hypothesis, and suggest free vitamin D metabolites may serve as preferable indicators of bone and mineral metabolism, particularly when clinical suspicion of DBP deficiency is high.

scholarly journals Association of Higher Plasma Vitamin D Binding Protein and Lower Free Calcitriol Levels with Tenofovir Disoproxil Fumarate Use and Plasma and Intracellular Tenofovir Pharmacokinetics: Cause of a Functional Vitamin D Deficiency?

2013 ◽  
Vol 57 (11) ◽  
pp. 5619-5628 ◽  
Author(s):  
Peter L. Havens ◽  
Jennifer J. Kiser ◽  
Charles B. Stephensen ◽  
Rohan Hazra ◽  
Patricia M. Flynn ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Vitamin D Deficiency ◽  
Tenofovir Disoproxil Fumarate ◽  
Binding Protein ◽  
Tubular Reabsorption ◽  
Plasma Vitamin ◽  
Calcium Balance ◽  
Vitamin D Binding Protein ◽  
Tenofovir Diphosphate

ABSTRACTTenofovir disoproxil fumarate (TDF) causes bone, endocrine, and renal changes by an unknown mechanism(s). Data are limited on tenofovir pharmacokinetics and these effects. Using baseline data from a multicenter study of HIV-infected youth on stable treatment with regimens containing TDF (n= 118) or lacking TDF (n= 85), we measured cross-sectional associations of TDF use with markers of renal function, vitamin D-calcium-parathyroid hormone balance, phosphate metabolism (tubular reabsorption of phosphate and fibroblast growth factor 23 [FGF23]), and bone turnover. Pharmacokinetic-pharmacodynamic associations with plasma tenofovir and intracellular tenofovir diphosphate concentrations were explored among those receiving TDF. The mean age was 20.9 (standard deviation [SD], 2.0) years; 63% were male; and 52% were African American. Compared to the no-TDF group, the TDF group showed lower mean estimated glomerular filtration rates and tubular reabsorption of phosphate, as well as higher parathyroid hormone and 1,25-dihydroxy vitamin D [1,25-OH(2)D] levels. The highest quintile of plasma tenofovir concentrations was associated with higher vitamin D binding protein, lower free 1,25-OH(2)D, higher 25-OH vitamin D, and higher serum calcium. The highest quintile of intracellular tenofovir diphosphate concentration was associated with lower FGF23. Higher plasma tenofovir concentrations were associated with higher vitamin D binding protein and lower free 1,25-OH(2)D, suggesting a functional vitamin D deficiency explaining TDF-associated increased parathyroid hormone. The finding of lower FGF23 accompanying higher intracellular tenofovir diphosphate suggests that different mechanisms mediate TDF-associated changes in phosphate handling. Separate pharmacokinetic properties may be associated with distinct TDF toxicities: tenofovir with parathyroid hormone and altered calcium balance and tenofovir diphosphate with hypophosphatemia and FGF23 regulation.IMPORTANCE(The clinical trial registration number for this study is NCT00490412 and is available online athttp://clinicaltrials.gov/ct2/show/NCT00490412.)

scholarly journals Vitamin D Binding Protein Impact on 25-Hydroxyvitamin D Levels under Different Physiologic and Pathologic Conditions

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Pegah Yousefzadeh ◽  
Sue A. Shapses ◽  
Xiangbing Wang
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Race And Ethnicity ◽  
Binding Protein ◽  
Vitamin D Binding Protein ◽  
Total Vitamin ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
High Prevalence ◽  
25 Hydroxyvitamin D

There is a high prevalence of vitamin D deficiency worldwide, but how to define vitamin D deficiency is controversial. Currently, the plasma concentration of total 25-hydroxyvitamin D [25(OH)D] is considered an indicator of vitamin D status. The free hormone hypothesis states that protein-bound hormones are inactive while unbound hormones are free to exert biological activity. The majority of circulating 25(OH)D and 1,25(OH)2D is tightly bound to vitamin D binding protein (DBP), 10–15% is bound to albumin, and less than 1% of circulating vitamin D exists in an unbound form. While DBP is relatively stable in most healthy populations, a recent study showed that there are gene polymorphisms associated with race and ethnicity that could alter DBP levels and binding affinity. Furthermore, in some clinical situations, total vitamin D levels are altered and knowing whether DBP is also altered may have treatment implications. The aim of this review is to assess DBP concentration in different physiological and pathophysiological conditions. We suggest that DBP should be considered in the interpretation of 25(OH)D levels.

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