Hypovitaminosis D in chronic kidney disease.

Abstract

BACKGROUND AND OBJECTIVES:

Recent studies show high prevalence of suboptimal 25-hydroxyvitamin D levels in chronic kidney disease patients. This study sought to test the hypothesis that the prevalence of 25-hydroxyvitamin D deficiency is significantly higher in chronic kidney disease patients and, in diabetic nephropathy, low serum 25-hydroxyvitamin D is associated with abnormal serum parathyroid hormone, bone mineral density, and coronary artery calcification.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:

Study A used data from the Third National Health and Nutrition Examination Survey. Study B was a post hoc analysis of an observational study of coronary artery calcification in non-dialysis-dependent diabetic nephropathy.

RESULTS:

In study A, the adjusted odds for 25-hydroxyvitamin D deficiency were 32% higher in chronic kidney disease patients. This higher prevalence of 25-hydroxyvitamin D deficiency, however, could not be explained by differences in total vitamin D intakes. The consequences of suboptimal 25-hydroxyvitamin D levels were analyzed in 146 patients with diabetic nephropathy. The significant, inverse relationship between serum 25-hydroxyvitamin D and parathyroid hormone levels was attenuated to a nonsignificant level on multivariate adjustment. There was a significant, inverse relationship between bone mineral density and coronary artery calcification scores; neither was independently associated with serum 25-hydroxyvitamin D. The serum 25-hydroxyvitamin D levels declined modestly in 72 patients studied after 12.4 +/- 0.4 mo.

CONCLUSIONS:

25-Hydroxyvitamin D deficiency is more common in chronic kidney disease, but this higher prevalence is unlikely to be a result of lower vitamin D intakes. The consequences of suboptimal 25-hydroxyvitamin D levels remain to be definitively elucidated.

• Authors: Rajnish Mehrotra, Dulcie Kermah, Matthew Budoff, Isidro B Salusky, Sang Shaou Mao, Yan Lin Gao, Junichiro Takasu, Sharon Adler, Keith Norris
• Journal: Clinical journal of the American Society of Nephrology : CJASN (Clin J Am Soc Nephrol) Vol. 3 Issue 4 Pg. 1144-51 (Jul 2008) ISSN: 1555-905X [Electronic] United States
• PMID: 18417740 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Parathyroid Hormone
• Vitamin D
• 25-hydroxyvitamin D

Topics

• Adult
• Aged
• Bone Density
• Calcinosis (blood, etiology)
• Chronic Disease
• Coronary Artery Disease (blood, etiology)
• Diabetic Nephropathies (blood, complications, epidemiology)
• Female
• Humans
• Kidney Diseases (blood, complications, epidemiology)
• Male
• Middle Aged
• Odds Ratio
• Parathyroid Hormone (blood)
• Prevalence
• Risk Assessment
• United States (epidemiology)
• Vitamin D (analogs & derivatives, blood)
• Vitamin D Deficiency (blood, complications, epidemiology, etiology)