scholarly journals Vitamin D Level in Predialysis Chronic Kidney Disease Patients Stage 3 to 5 and Predictors of its Deficiency

2021 ◽  
pp. 64-72
Author(s):  
Mohamed G. Mohamed ◽  
Hanaa I. Okda ◽  
Hossam A. Hodeib ◽  
Mostafa T. Gabr
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Ckd Stage ◽  
Significant Difference

Background: Vitamin D deficiency is commonly encountered in patients with chronic kidney disease (CKD) with or without undergoing dialysis. This study was conducted to assess vitamin D level in patients diagnosed with predialysis CKD stage 3 – 5, and to determine the predictors of its deficiency in such patients. Materials and Methods: This cross-sectional study included 75 patients who were divided into three equal groups of CKD-3, CKD-4 and CKD-5. All cases were subjected to detailed history taking, physical examination and measurement of estimated glomerular filtration rate (eGFR) according to Cockcroft-Gault formula. In addition, laboratory investigations included CBC, renal function tests, serum ferritin, intact parathyroid hormone (iPTH) and vitamin D level. Results: Patient demographics and other co-morbidities were comparable among the three groups. Serum vitamin D had mean values of 24.84, 20.52 and 11.24 ng/ml in patients with stages III, IV and V respectively, with significant difference between the three groups. Vitamin D deficiency was more common in CKD-5 cases. On the contrary, serum parathyroid hormone and ferritin were significantly higher levels, in patients with higher stages. There was statistically significant positive correlation of serumvitamin D with eGFR, Hb, calcium and albumin. On the other hand, serum vitamin D was negatively correlated with phosphate, PTH, urea andcreatinine. Conclusion: It is evident that higher stages of CKD are associated with more vitamin D deficiency.

SUBLINGUAL VITAMIN D3 DRUG THERAPY IN VITAMIN D DEFICIENCY PATIENTS AT PRAVARA RURAL HOSPITAL

2019 ◽  
pp. 18-20
Author(s):  
Sanjeeva Kumar Goud T ◽  
Rahul Kunkulol
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Significant Difference ◽  
Before And After

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route

scholarly journals Estimation of Serum Vitamin D, Calcium and Phosphorus in Chronic Kidney Disease

2017 ◽  
Vol 16 (1) ◽  
pp. 30-36
Author(s):  
Ajay Rajbhandari ◽  
Rajendra Kumar Agrawal ◽  
Anil Baral ◽  
Anil Pokhrel ◽  
Dineshwori Shrestha ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Serum Vitamin ◽  
Hypovitaminosis D ◽  
Serum Phosphorus ◽  
Phosphate Binders ◽  
Serum Vitamin D ◽  
Ckd Stage ◽  
Calcium And Phosphorus

Introduction: Abnormalities in mineral metabolism are invariable with progressive deterioration of kidney function in chronic kidney disease (CKD). These abnormalities are documented in CKD on dialysis in our population but not on pre dialysis. So, present study aims to estimate serum vitamin D, calcium and phosphorus in CKD stage 3-5ND. Methods: It was a cross sectional study of established new CKD patients not on dialysis, vitamin D, calcium, phosphate binders and corticosteroids therapy. Blood sample was drawn for estimation of serum vitamin D, creatinine, calcium, phosphorus and albumin and CKD staging done by KDIGO (2012) criteria. SPSS software version 19 was used for data analysis and chi-squared and ANOVA test was applied as the test of significance.Results: Sixty six (51 male and 15 female) CKD patients with a mean age of 54.3±14.8 years were studied. Hypovitaminosis D (<30 ng/ml) was present in 84.8%, with deficiency (<20 ng/ml) in 50% and insufficiency (20-30) ng/ml in 34.8%. Other abnormalities observed were hypocalcemia (60.6%), hypercalcemia (1.5%) and hyperphosphatemia (63.6%) with no difference of corrected calcium, significant difference of serum phosphorus (p<0.001) with hyperphosphatemia in stage 4 and 5 CKD and vitamin D insufficiency in stage 3b, deficiency in stage 3a, 4 and 5 CKD. There was no correlation of serum vitamin D with calcium and phosphorus in different stages of CKD.Conclusion: Present study concludes that hypovitaminosis D, hypocalcemia and hyperphosphatemia is common in our pre-dialysis CKD patients and serum phosphorus raises more with reduction of GFR. 

scholarly journals SERUM 25-HYDROXY VITAMIN D;

2017 ◽  
Vol 24 (03) ◽  
pp. 375-380
Author(s):  
Shazia Memon ◽  
Farzana Shiakh ◽  
Asadullah Makhdoom ◽  
S. M. Tahir
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Vitamin D Deficiency ◽  
Bone Mineral ◽  
Serum Vitamin ◽  
Mineral Density ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Low Serum

Deficiency of vitamin D is an emerging issue in children worldwide. It has beenobserved that all patients with vitamin D deficiency does not manifest clinical features or hyperparathyroidresponse. In this study we have evaluated the interaction of serum vitamin D level,parathyroid hormone (PTH) level and bone mineral density (BMD) in children. Objectives: Ourobjectives were to determine the frequency of Vitamin D deficiency in children and association oflow serum D level with serum parathyroid level and bone mineral density (BMD). Study Design:Descriptive cross sectional study. Period: June 2012 to May 2014. Setting: Pediatric and Orthopediatricout-patient departments. Material & Methods: A total of 500 children up to 15 yearswith low serum vitamin D level were enrolled to analyze the interaction of Serum vitamin D, PTHand BMD. Patients were divided in groups on the basis of serum PTH. We have categorize thedeficiency of Vitamin D on the basis of level of 25OHD. It was defined as severe (25OHD ≤ 5ng/ml), moderate (25OHD≤ 10 ng/ml) and mild (25OHD ≤ 20 ng/ml) and hyperparathyroidism(SHPT) was valued if level >65 pg/ml. All children with 25OH ≤ 20 ng/ml were included andassociation with SHPT and BMD were measured. Results: It has been observed that 30–40%of patients with moderate and severe deficiency of vitamin D respectively had shown increasedlevel of PTH. Bone mineral density has demonstrated decline pattern from PTH Quartile 1toQuartile 4 at all sites in children, with only minimal difference (decreasing trend) in serum25OHD levels between these quartiles. The critical level of parathyroid hormone beyond whichBMD going to decline is 35 pg/ml. No demonstrable difference has been observed in BMDwithin each PTH quartile according to categorization of Vitamin D Deficiency. Conclusions:Around 40% of the patients having low serum vitamin D level demonstrated SHPT. Regardingthe BMD levels, it begins to decreases at PTH levels currently well thought-out to be normal.So there is a need to re-define SHPT among different age groups considering the relationshiplinking PTH and BMD. This may also affect guidelines regarding vitamin d supplementation inpatients with vitamin D deficiency.

Clinical factors correlated with vitamin D deficiency in patients with obesity scheduled for bariatric surgery: A single center experience

2020 ◽  
Vol 90 (3-4) ◽  
pp. 346-352
Author(s):  
Vincenzo Pilone ◽  
Salvatore Tramontano ◽  
Carmen Cutolo ◽  
Federica Marchese ◽  
Antonio Maria Pagano ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Inverse Correlation ◽  
Model Assessment ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Female Sex ◽  
Vitamin D Levels

Abstract. We aim to assess the prevalence of vitamin D deficiency (VDD) in patients scheduled for bariatric surgery (BS), and to identify factors that might be associated with VDD. We conducted a cross-sectional observational study involving all consecutive patients scheduled for BS from 2017 to 2019. The exclusion criteria were missing data for vitamin D levels, intake of vitamin D supplements in the 3 months prior to serum vitamin D determination, and renal insufficiency. A total of 206 patients (mean age and body mass index [BMI] of 34.9 ± 10.7 years, and 44.3 ± 6.99 kg/m2, respectively) met the inclusion criteria and were enrolled for data analysis. VDD (<19.9 ng/mL), severe VDD (<10 ng/mL), and vitamin D insufficiency (20–29.9 ng/mL) were present in 68.8 %, 12.5 %, and 31.2 % of patients, respectively. A significant inverse correlation was found between vitamin D levels and initial BMI, parathyroid hormone, and homeostatic model assessment of insulin resistance (r = −0.280, p < 0.05; r = −0.407, p = 0.038; r = −0.445, p = 0.005), respectively. VDD was significantly more prevalent in patients with higher BMI [−0.413 ± 0.12, CI95 % (−0.659; −0.167), p = 0.006], whereas no significant association between hypertension [−1.005 ± 1.65, CI95 % (−4.338; 2.326), p = 0.001], and diabetes type 2 (T2D) [−0.44 ± 2.20, CI95 % (−4.876; 3.986), p = 0.841] was found. We observed significant association between female sex and levels of vitamin D [6.69 ± 2.31, CI95 % (2.06; 11.33), p = 0.006]. The present study shows that in patients scheduled for BS, VDD deficiency is common and was associated with higher BMI, and female sex.

scholarly journals P0898VITAMIN C STATUS MODIFIES PARATHYROID HORMONE SECRETION IN NON-DIALYZED CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ryuta Fujimura ◽  
SHOGO SHIBATA ◽  
Takechiyo Tokuda ◽  
Ayako Tanaka ◽  
Aya Mizumoto ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Kidney Disease ◽  
Vitamin C ◽  
Secondary Hyperparathyroidism ◽  
Hormone Secretion ◽  
Serum Vitamin ◽  
Serum Phosphate ◽  
Vitamin C Deficiency

Abstract Background and Aims Among patients with chronic kidney disease (CKD) at predialysis stage, there is a high incidence of secondary hyperparathyroidism. Metabolic changes associated with secondary hyperparathyroidism lead to renal osteodystrophy, including osteitis fibrosa, ectopic calcification, cardiovascular disease, and the risk of death, and serum parathyroid hormone levels are influenced by nutritional variables. Non-dialyzed CKD patients are especially prone to vitamin C deficiency because of dietary restrictions and malnutrition. Vitamin C is an important antioxidant and relates to the development and maintenance of bone tissues. However, the contribution of vitamin C deficiency to parathyroid hormone secretion is unknown. Here, we performed a single-center cross-sectional study in order to assess association of serum vitamin C and parathyroid hormone in non-dialyzed CKD patients. Method We had 280 consecutive patients who underwent serum vitamin C and serum intact parathyroid hormone (iPTH) measurement for screening purposes from January 1st, 2013 to November 30th, 2017. We analysed a total of 128 patients (71.3±11.6 year-old, 80 males) who had an estimated glomerular filtration rate (eGFR) that remained less than 60 mL/min/1.73m2 after 152 patients were excluded because of vitamin C or vitamin D supplementation, age &lt;20 years, dialysis, positive serostatus for HIV, hepatitis B or hepatitis C, chronic infection, or cancer. Results Twenty-three percent of the patients (n=29) had vitamin C levels&lt; 2.0 μg/mL (a range seen in very deficient subjects), 53% (n=68) had levels between 2.0 and 5.5 μg/mL, and 31 patients (24%) had vitamin C levels &gt;5.5 μg/mL, which is considered the upper limit of normal for the healthy population. Log(iPTH) significantly correlated with age (r=-0.238, p=0.00672), log(eGFR) (r=-0.625, p&lt;0.0001), serum calcium (r=-0.609, p&lt;0.0001), and serum phosphate (r=0.41, p&lt;0.0001), and had a tendency to correlate with serum albumin (r=-0.146, p=0.101). Low serum vitamin C was associated with higher serum iPTH (P=0.0005, one-way analysis of variance). In a multiple linear regression model with log(iPTH) as the dependent variable, and age, gender, log(eGFR), serum levels of calcium, phosphate, albumin, and vitamin C as independent variables, the inverse relationship of log(iPTH) and serum vitamin C was confirmed (R2 = 0.568, adjusted R2 = 0.543, P&lt;0.0001), along with other parameters influencing iPTH levels, including age, log(eGFR), serum calcium, and serum phosphate. Low vitamin C levels were also associated with increased serum alkaline phosphatase (r=-0.209, p=0.0179), a further indicator of the impact of vitamin C status on bone metabolism. Conclusion Vitamin C deficiency is prevalent in a significant proportion of non-dialyzed CKD patients. Low vitamin C levels contribute to secondary hyperparathyroidism, leading to increased bone turnover. This novel observation may result from effects of vitamin C on vitamin D metabolism, vitamin D binding in target tissues, and cAMP-linked signalling pathways in bone and parathyroid gland. Therapeutic intervention with supplemental vitamin C for secondary hyperparathyroidism might be a good strategy.

scholarly journals Association of vitamin D with adiposity measures and other determinants in a cross-sectional study of Cypriot adolescents

2014 ◽  
Vol 18 (1) ◽  
pp. 112-121 ◽  
Author(s):  
Ourania Kolokotroni ◽  
Anna Papadopoulou ◽  
Panayiotis K Yiallouros ◽  
Vasilios Raftopoulos ◽  
Christiana Kouta ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Reference Group ◽  
Serum Vitamin ◽  
Sun Exposure ◽  
Dietary Vitamin ◽  
Vitamin D Status ◽  
Fat Percentage ◽  
Cross Sectional ◽  
Serum Vitamin D

AbstractObjectiveTo assess vitamin D status among Cypriot adolescents and investigate potential determinants including BMI and body fat percentage (BF%).DesignParticipants had cross-sectional assessments of serum vitamin D, physical activity, dietary vitamin D intake and sun exposure. Linear and logistic regression models were used to explore the associations of vitamin D with potential predictors.SettingHospitals, Cyprus, November 2007–May 2008.SubjectsAdolescents (n 671) aged 16–18 years.ResultsMean serum vitamin D was 22·90 (sd 6·41) ng/ml. Only one in ten children had sufficient levels of vitamin D (≥30 ng/ml), while the prevalence of vitamin D deficiency (12–20 ng/ml) and severe deficiency (<12 ng/ml) was 31·7 % and 4·0 %, respectively. Lower vitamin D was associated with winter and spring season, female gender, reduced sun exposure in winter and darker skin. Participants with highest BMI and BF% when compared with a middle reference group had increased adjusted odds of vitamin D insufficiency (OR = 3·00; 95 % CI 1·21, 7·45 and OR = 5·02; 95 % CI 1·80, 13·97, respectively). A similar pattern, although not as strong, was shown for vitamin D deficiency with BF% (OR = 1·81; 95 % CI 1·04, 3·16) and BMI (OR = 1·51; 95 % CI 0·85, 2·67). Participants in the lowest BMI and BF% groups also displayed compromised vitamin D status, suggesting a U-shaped association.ConclusionsVitamin D deficiency in adolescence is very prevalent in sunny Cyprus, particularly among females, those with darker skin and those with reduced sun exposure in winter. Furthermore, vitamin D status appears to have a U-shaped association with adiposity measures.

scholarly journals VITAMIN D DEFICIENCY;

2012 ◽  
Vol 19 (02) ◽  
pp. 208-213
Author(s):  
MUHAMMAD ASLAM ◽  
ZAHID MASOOD ◽  
Abdul SATTAR ◽  
Maria Qudsia
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Sampling Technique ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Vitamin D 3

Objective: To study the Prevalence of Vitamin D deficiency in pregnant women. Study Design: A Cross-sectional analyticalstudy through convenient sampling technique. Setting and duration: At a private Clinic located at East Canal Road Faisalabad, from March2011 to June 2011. Material and method: The study included consecutive 61 pregnant women of reproductive age and non-pregnant womenwere excluded. Blood samples were taken in morning i.e. overnight fasting samples, by venepuncture by disposable syringes sample weretaken and samples were stored at -20 degree centigrade till they were analyzed. Our interest was in age and serum Vitamin D 3 levels. Results:Out of 61 pregnant women results showed that 87.0% pregnant women were having Vitamin D deficiency, 10.0% were having Vitamin Dinsufficiency, 3.0% had Vitamin D sufficiency and none shows Vitamin D intoxication. Vitamin D deficiency was more prevalent in pregnantwomen of younger age group. Furthermore prevalence was higher among the pregnant mothers with high parity. Moreover, 65% women werenot exposed to sunlight properly, 60% women had muscle cramps and bony aches. 90% women never were tested for tested Vitamin D levelsbefore. Conclusions: Prevalence of Vitamin D deficiency is significant in pregnant women. It is also important for its effects on various organsand systems of body as well as on pregnancy and neonate. The different aspects of study led to conclusion to emphasize that Health educationbe imparted to pregnant women and their families in terms of diet, proper sunlight exposure and taking Vitamin D supplements in pregnancy. It isthus recommended to perform Vitamin D levels in every pregnant woman.

scholarly journals VITAMIN D;

2019 ◽  
Vol 26 (04) ◽  
Author(s):  
Tanveer Hussain Shah ◽  
Tahir Saeed Siddiqui ◽  
Ahmad Zeb
Keyword(s):  
Vitamin D ◽  
Daily Intake ◽  
Serum Vitamin ◽  
Cross Sectional Study ◽  
Age Group ◽  
Vitamin D Status ◽  
School Students ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Significant Difference

Background: Present study was designed by keeping in view the importance of vitamin D in adolescents’ age group. Objectives: To explore the cases of low vitamin D status (<50 nmol/l) with respect to age & sex factors in school students. Study Design: Observation cross-sectional study. Setting: Department of Biochemistry faculty of Health Sciences, Hazara University Mansehra, Ayub Medical College and Teaching Hospital Abbottabad. Period: June 2014 to June 2015. Subject & Methods: We recorded daily intake of vitamin D of each individual and  measured serum 25 hydrxoy vitamin D in a school based cross sectional sample of adolescents girls (n=93) and boys (n=96) students. Results: Results of this study reflected that, out of total boys and girls students, 16% and 39% of the sample  respectively showed low serum vitamin D status(<50 nmol/l). Number of cases had low vitamin D level increased with age in girls and decreased with age in boys. Serum vitamin D concentration was decreased with increase in age of girls and found significantly low (p=0.0087) in higher age group (>13-≤16).  No significant difference (p=0.29) was noted regarding daily intake of vitamin D between lower & higher age. Conclusion: It is concluded that, age and sex might be contributory factors in the occurrence of low vitamin D status.

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