Study of Vitamin D levels in patients with Chronic Kidney Disease

Introduction: Apart from classical functions, vitamin D has autocrine function. Autocrine function of vitamin D has a potential impact on the morbidity and mortality in the Chronic Kidney Disease patients. This study is undertaken to observe probable modality, if present, between post Hemodialysis (HD) decrease in vitamin D levels and clinical deterioration in CKD patients.Method & Material: 63 patients (32 males and 31 females) of Stage – 5 CKD were studied. There vitamin D was estimated before and after HD on first and subsequent maintenance HDs all patients with or without comorbidities.Results: Pre HD total vitamin D levels were ‘deficient’ (58.73%) and ‘sufficient’ in 38.1%, almost equal in patients of both sexes despite intake of supplement containing Calcium and Calcitriol. Post HD vitamin D levels were detected to be markedly low, seems to be ‘washed out’ during HD, in 85.71% of patients (29 males and 27). Vitamin D ‘wash out’ effect was also observed in subsequent maintenance HDs. Females and elderly patients were more prone to vitamin D ‘wash out’. Conventional therapy with vitamin D supplements can replenish but could not prevent its post HD ‘wash out’.Conclusion: It seems, in CKD the deleterious effects of post HD vitamin D deficiency are due to appreciable autocrine dysfunctions resulting in cardio vascular diseases (CVDs) and comorbidities especially diabetes mellitus add to worsening of CVDs, which are the main causes of high morbidity and mortality in these patients.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.652-660

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Vitamin D (25 ( OH) D ) in patients with chronic kidney disease stages 2-5

Colombia Medica ◽

10.25100/cm.v47i3.2148 ◽

2016 ◽

pp. 160-166 ◽

Cited By ~ 6

Author(s):

César Augusto Restrepo Valencia ◽

Jose Vicente Aguirre Arango

Keyword(s):

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Statistical Methods ◽

Laboratory Tests ◽

Chronic Kidney Disease Stage ◽

Sun Exposure ◽

Disease Stage ◽

Disease Etiology ◽

Vitamin D Levels

Objective: To determine whether patients with chronic kidney disease (CKD) without dialysis their stage impacts the native vitamin D levels. Methods: Patients over 18 years with chronic kidney disease stage 2-5 without dialysis treatment. They demographic, anthropometric variables, degree of sun exposure, disease etiology and laboratory variables related to bone and mineral disorders were evaluated. Study analytical cross-sectional prospective. Descriptive statistical methods for quantitative and qualitative are characterized, and analytical correlation between levels of vitamin D statistical laboratory tests related to bone and mineral disorders, sun exposure and ethnicity variables for each stage were characterized. By descriptive statistical methods, quantitative and qualitative variables were characterized, and analytical statistical correlation between levels of vitamin D with laboratory tests related to bone and mineral disorders, sun exposure and ethnicity for each stage were practiced. Results: 331 patients were evaluated, with a mean age of 71 years, the mestizo majority (71%), 173 women, main etiology of CKD hypertensive nephropathy (33.2%). 21.1% of patients had normal levels of vitamin D, 70.1% insufficient, and 8.8% in deficit. Negative correlation was detected between the levels of vitamin 25(OH)D and serum creatinine, phosphorus, calcium x phosphorus product, PTH, proteins in urine 24 hours and BMI. Positive correlation for calcium and albumin. Positive statistical significance between the levels of vitamin 25(OH)D and sun exposure for 3b and 4 stages was found. Conclusions: In patients with CKD is common to detect low levels of vitamin 25(OH)D, which can contribute to the generation of secondary hyperparathyroidism.

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Vitamin D Levels in Chronic Kidney Disease Stage 3, 4, and 5

Althea Medical Journal ◽

10.15850/amj.v5n4.1494 ◽

2018 ◽

Vol 5 (4) ◽

pp. 168-174

Author(s):

David Kristianus ◽

Rudi Supriyadi ◽

Siska Wiramihardja

Keyword(s):

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Chronic Kidney Disease Stage ◽

Disease Stage ◽

Vitamin D Levels

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Treatment Failure of Active Vitamin D Therapy in Chronic Kidney Disease: Predictive Factors

American Journal of Nephrology ◽

10.1159/000441095 ◽

2015 ◽

Vol 42 (3) ◽

pp. 228-236 ◽

Cited By ~ 2

Author(s):

Mario Cozzolino ◽

Adrian Covic ◽

Blanca Martinez-Placencia ◽

Konstantinos Xynos

Keyword(s):

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Treatment Failure ◽

Serum Levels ◽

Clinical Effects ◽

Active Vitamin ◽

Ipth Level ◽

Active Vitamin D ◽

Vitamin D Levels

Background: In patients with chronic kidney disease (CKD), impaired renal function leads to decreased vitamin D levels, which causes an increase in parathyroid hormone (PTH) production and contributes to the development of secondary hyperparathyroidism (SHPT). This may result in adverse clinical effects such as bone disorders, vascular calcification, cardiovascular disease, and increased mortality. Current treatment practices and associated outcomes with active vitamin D treatment in patients with CKD were reviewed with the objective to assess parameters (such as PTH and serum calcium levels) that may be used to define the failure of vitamin D treatment. Summary: Reports based on observational data have noted improved outcomes with active vitamin D treatment (calcitriol, paricalcitol, alfacalcidol, or doxercalciferol) in patients with CKD. Criteria for the identification of active vitamin D treatment failure are unclear from current guidelines, although up to 50% of patients may experience treatment failure eventually because of development of hypercalcemia or resistant SHPT, characterized by an elevated intact PTH (iPTH) level despite treatment. We propose a definition of vitamin D treatment failure as iPTH >600 pg/ml after 6 months of intravenous active vitamin D treatment and corrected total calcium serum levels >10.2 mg/dl, and review factors that may predict the response to vitamin D treatment. Key Message: Active vitamin D treatment failure is an important challenge in clinical practice. The aim of the proposed definition is to suggest a possible framework for hypothesis generation and to encourage further research into this common problem.

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P0891META-ANALYSIS OF NUTRITIONAL VITAMIN D FOR THE TREATMENT OF SECONDARY HYPERPARATHYROIDISM IN PATIENTS WITH NON-DIALYSIS CHRONIC KIDNEY DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0891 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Joel Gunnarsson ◽

Rosa Lauppe ◽

Edelgard Kaiser ◽

Marco Soro ◽

Philipp Csomor

Keyword(s):

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Secondary Hyperparathyroidism ◽

Fixed Effects ◽

Untreated Patient ◽

Critical Role ◽

Vitamin D Levels ◽

Patient Groups ◽

Nutritional Vitamin

Abstract Background and Aims Chronic kidney disease (CKD) is commonly associated with mineral and bone disorder (CKD-MBD). Secondary hyperparathyroidism (SHPT) is a critical component of CKD-MBD characterized by excessive PTH secretion and parathyroid hyperplasia. SHPT develops in CKD because of disturbances in CKD-MBD parameters such as increases in serum phosphate and fibroblast growth factor 23, and reductions in 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D) and serum calcium. Low vitamin D levels play a critical role in the development and progression of SHPT. Nutritional vitamin D (NVD) supplements are being frequently used to address SHPT, especially in early CKD. The objective of this meta-analysis (MA) was to evaluate the effectiveness of the NVDs cholecalciferol and ergocalciferol in reducing PTH and increasing 25(OH)D in patients with non-dialysis CKD (ND-CKD). Method A systematic literature search was performed in PubMed to identify relevant randomized control trials (RCTs) to be included in the MA. All analyses were performed using both random and fixed effects models with inverted-variance weighting. Comparisons were made between the effects of NVDs relative to placebo-treated or untreated patients and between the baseline and end-of-study values of the patients treated with the NVDs, i.e. the effects in treated patients only. Results A total of 14 RCTs comprising 974 patients were included in the analyses. Overall reductions in PTH were small when compared to baseline (reduction of 10.95 pg/ml, 95 % confidence interval (CI): -15.99 to -5.91 pg/ml), while reductions in PTH were approximately three times larger when compared to placebo-treated or untreated patient groups (reduction of 34.35 pg/ml, 95 % CI:-47.47 to -21.24 pg/ml). This indicated a limited potential to actively lower PTH with NVDs as the relative effect on PTH when compared to placebo-treated or untreated patient groups was driven to a large degree by increases in PTH in the comparator arms. Treatment with NVDs tended to increase levels of 25(OH)D both when compared to placebo-treated or untreated patients (increase of 26.54 ng/ml, 95 % CI: 24.62 to 28.46 ng/ml) and when only the changes in treated patients were considered (increase of 21.49 ng/ml, 95 % CI: 20.54 to 22.44 ng/ml). However, large variations in effect sizes on levels of 25(OH)D were observed, making judgements about the size of any true treatment effect difficult. Average levels of 25(OH)D in treated patients at the end of the study period were >30 ng/ml in all but two RCTs and >50 ng/ml in only five of the included RCTs. No clear relationship was observed between study length (range: 4 to 144 weeks) or doses administered (range: 14 000 to 75 000 UI weekly average) and effects on 25(OH)D or PTH. Conclusion Our results suggest that treatment with NVDs is not efficacious to reliably and consistently lower PTH in ND-CKD patients with SHPT. Although treatment with NVDs can potentially be used to correct vitamin D insufficiency, our results suggest that the potential of NVD treatment to raise 25(OH)D levels to >50 ng/ml, a level needed to reduce PTH, is limited.

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Vitamin D levels in patients with diabetes mellitus in combination with chronic kidney disease

Nephrology (Saint-Petersburg) ◽

10.36485/1561-6274-2021-25-6-81-86 ◽

2021 ◽

Vol 25 (6) ◽

pp. 81-86

Author(s):

A. P. Lichacheva ◽

N. V. Agranovich ◽

A. T. Klassova ◽

A. S. Anopchenko ◽

E. L. Solovyova

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Metabolic Effects ◽

Control Group ◽

Excretory Function ◽

Vitamin D Levels ◽

Wide Range ◽

Patients With Diabetes

BACKGROUND. Vitamin D has been known since 1928. The wide range of its metabolic effects paradoxically contrasts with the high prevalence of insufficiency and deficiency in the population of different regions of the world. A number of publications have demonstrated information about the relationship between vitamin D and insulin production by beta cells of the pancreas, as well as the excretory function of the kidneys.THE AIM: to assess the level of vitamin D in patients with diabetes mellitus in combination with chronic kidney disease (CKD).PATIENTS AND METHODS. A questionnaire and a study of the level of 25-hydroxyvitamin D, creatinine, urea, and glucose in the blood were conducted in 117 patients aged 18 to 84 years who gave voluntary consent. All patients were divided into three study groups: group 1 - patients with long-term DM, group 2 - patients with newly diagnosed DM, and 3 - control group. The glomerular filtration rate (GFR) is calculated by the formula CKD-EPI.RESULTS. As a result of the study, it was found that patients with DM, regardless of the duration of its course, were more likely to suffer from vitamin D deficiency, compared with the control group, where D-deficiency and D-deficiency occurred with the same frequency. In addition, patients with DM were more likely to have stage 2-3A CKD, in contrast to the control group, where preserved kidney function prevailed. We also identified and confirmed the direct dependence of GFR on the level of vitamin D in the blood of patients with DM.CONCLUSION. In the patients studied by us, a clear association was found between a lower vitamin D index in the blood serum and the presence of a history of diabetes. They also showed a tendency to decrease the excretory function of the kidneys and the formation of CKD. Consequently, a full-fledged diagnosis of vitamin D-deficient conditions and timely initiated therapy can prevent or at least slow down the progression of CKD in these patients, which will certainly improve their quality of life and reduce the costs of health services for renal replacement therapy and rehabilitation of this group of patients.

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The effects of changing vitamin D levels on anemia in chronic kidney disease patients: a retrospective cohort review

Clinical Nephrology ◽

10.5414/cnp74025 ◽

2010 ◽

Vol 74 (07) ◽

pp. 25-32 ◽

Cited By ~ 24

Author(s):

P.T. Lac ◽

K. Choi ◽

I.-A. Liu ◽

S. Meguerditchian ◽

S.A. Rasgon ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Retrospective Cohort ◽

Vitamin D Levels

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Free 25-Vitamin D Is Correlated with Cardiovascular Events in Prevalent Hemodialysis Patients but Not with Markers of Renal Mineral Bone Disease

Kidney & Blood Pressure Research ◽

10.1159/000499878 ◽

2019 ◽

Vol 44 (3) ◽

pp. 344-353 ◽

Cited By ~ 1

Author(s):

Xin Chen ◽

Yong-Ping Lu ◽

Ting Luo ◽

Hong-Wei Wu ◽

Su-Fen Cai ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Cardiovascular Events ◽

Hemodialysis Patients ◽

Biologically Active ◽

Blood Concentrations ◽

Coronary Syndrome ◽

Vitamin D Levels ◽

Free Vitamin D

Free vitamin D is the biologically active form of vitamin D. Vitamin D deficiency is associated with cardiovascular disease, the most common cause of mortality in hemodialysis patients. The goal of our current study was to investigate the relation between blood concentrations of free 25-hydroxyvitamin D with cardiovascular events in end-stage chronic kidney disease patients on hemodialysis, because this is unknown so far. We measured free vitamin D levels in 117 stable consecutive prevalent patients in September as a surrogate of vitamin D exposure during the past 6 months, and recorded the number of cardiovascular events during the previous 6 months defined as hospitalization due to heart failure, episodes of acute coronary syndrome, and stroke. Fourteen events occurred during the observation period. In patients without any cardiovascular events the free vitamin D levels were significantly higher as compared to those with cardiovascular events (patients without events: 5.68 [4.37–9.27] pg/mL; patients with events: 4.74 [3.46–5.37] pg/mL, p = 0.015). This finding remained stable after multiple regression analysis considering confounding factors such as age, time on dialysis, preexisting diabetes, hypertension, and coronary heart disease. In conclusion, our study shows that free vitamin D serum concentrations are independently associated with major cardiovascular events in chronic kidney disease patients on dialysis.

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Influence of vitamin D levels on the treatment of premature ventricular complexes in patients with chronic kidney disease

IJC Metabolic & Endocrine ◽

10.1016/j.ijcme.2017.01.002 ◽

2017 ◽

Vol 14 ◽

pp. 53-58 ◽

Cited By ~ 3

Author(s):

Márcio Galindo Kiuchi ◽

Gustavo Ramalho e Silva ◽

Luis Marcelo Rodrigues Paz ◽

Shaojie Chen ◽

Neil Alexander Hoye ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Vitamin D ◽

Kidney Disease ◽

Premature Ventricular Complexes ◽

Vitamin D Levels

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

ISRN Endocrinology ◽

10.5402/2011/109458 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 8

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.

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