Professional paper
VITAMIN D IN PATIENTS WITH CHRONIC KIDNEY DISEASE TREATED WITH HEMODIALYSIS
IVICA HORVATIĆ
orcid.org/0000-0001-9050-5747
; Dubrava University Hospital, Department of Nephrology and Dialysis; School of Medicine, University of Zagreb, Zagreb, Croatia
DRAŠKO PAVLOVIĆ
orcid.org/0000-0002-2380-869X
; B. Braun Avitum Polyclinic for Internal Medicine and Dialysis, Zagreb, Croatia
IVANČICA HRŠAK
; B. Braun Avitum Polyclinic for Internal Medicine and Dialysis, Zagreb, Croatia
SONJA DITS
; B. Braun Avitum Polyclinic for Internal Medicine and Dialysis, Zagreb, Croatia
BORIS KUDUMIJA
orcid.org/0000-0002-6717-5871
; B. Braun Avitum Polyclinic for Internal Medicine and Dialysis, Zagreb, Croatia
Abstract
The aim of this study was to determine vitamin D status in patients with end-stage kidney disease (ESKD) treated with chronic hemodialysis and its relationship with basic clinical and laboratory parameters in these patients. The cross-sectional observational retrospective study was carried out in patients treated at B. Braun Avitum Internal Medicine and Dialysis Polylinic. Serum 25OH-vitamin D (25(OH)D) was determined; other parameters included were age and gender, length of hemodialysis treatment, fi nding of diabetes mellitus, serum concentrations of parathyroid hormone (PTH), calcium, phosphate, albumin and C-reactive protein (CRP). Based on 25(OH)D serum concentrations, patients were classifi ed into 3 groups as follows: defi ciency (<50 nmol/L), insuffi ciency (50-70 nmol/L) and suffi ciency (>75 nmol/L). Between group differences were analyzed with t-test and one-way ANOVA for continuous variables, and χ2-test for categorical variables. The level of statistical signifi cance was set at p<0.05. The study included 134 patients (age 68±15 years, mean hemodialysis treatment length 5.9±6.3 years), of which 43 (32.1 % were women. Vitamin D defi ciency was found in 65 (48.5%) and insuffi ciency in 35 (26.1%) patients. Most patients were on monotherapy with paricalcitol (50 patients) and on paricalcitol+cholecalciferol therapy (34 patients). Patients with vitamin D defi ciency were younger compared to patients with vitamin D suffi ciency (65 vs. 73 years; p=0.046) and had more often diabetes compared to the other two groups (p=0.018). Additional analysis comparing defi cient patients with the other two groups combined (25(OH)D <50 nmol/L vs. >50 nmol/L) showed that those with defi ciency had higher PTH (40.78 vs. 28.42 pmol/L, p=0.003), higher phosphate (1.72 vs. 1.53 mmol/L, p=0.039), lower CRP (18.9 vs. 26.7 mg/L, p=0.019) and more often diabetes (29/65 vs. 16/69, p=0.011). These results showed a high prevalence of vitamin D defi ciency and insuffi ciency in patients with ESKD despite supplementation and treatment. Additional randomized and prospective studies are necessary to determine optimal treatment regimen, as well as its effects on morbidity and mortality.
Keywords
vitamin D; parathormone; chronic kidney disease; hemodialysis; hyperparathyroidism; mineral-bone disorder
Hrčak ID:
294710
URI
Publication date:
27.2.2023.
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