Samina Khan1. 1. Tufts University School of Medicine, Box 391, 750 Washington Street, Boston, MA 02459, USA. skhan@tufts-nemc.org
Abstract
BACKGROUND: Chronic kidney disease (CKD) is associated with morbid complications that lead to high mortality and costs. Vitamin D deficiency and secondary hyperparathyroidism (SHPT) are frequent complications of CKD. METHODS: We reviewed the current literature regarding the prevalence, diagnosis, complications, and management of vitamin D deficiency and SHPT among patients with CKD. RESULTS: There is a high prevalence of vitamin D deficiency among adolescents and adults in the United States (age and gender dependent). Patients with CKD or those who are dialysis-dependent are much more likely to have low levels of vitamin D in comparison to those without kidney disease. In order to avoid significant complications including SHPT and musculoskelatal diseases, vitamin D needs to be measured routinely by primary care physicians and nephrologists. In the majority of CKD patients, SHPT is not diagnosed until late, leading to advanced cardiovascular and bone diseases. CONCLUSIONS: In conclusion, current management of vitamin D deficiency and SHPT is suboptimal. Early diagnosis of vitamin D deficiency and SHPT are integral to optimal management of CKD, and additional research is needed in this area.
BACKGROUND:Chronic kidney disease (CKD) is associated with morbid complications that lead to high mortality and costs. Vitamin Ddeficiency and secondary hyperparathyroidism (SHPT) are frequent complications of CKD. METHODS: We reviewed the current literature regarding the prevalence, diagnosis, complications, and management of vitamin D deficiency and SHPT among patients with CKD. RESULTS: There is a high prevalence of vitamin D deficiency among adolescents and adults in the United States (age and gender dependent). Patients with CKD or those who are dialysis-dependent are much more likely to have low levels of vitamin D in comparison to those without kidney disease. In order to avoid significant complications including SHPT and musculoskelatal diseases, vitamin D needs to be measured routinely by primary care physicians and nephrologists. In the majority of CKDpatients, SHPT is not diagnosed until late, leading to advanced cardiovascular and bone diseases. CONCLUSIONS: In conclusion, current management of vitamin D deficiency and SHPT is suboptimal. Early diagnosis of vitamin D deficiency and SHPT are integral to optimal management of CKD, and additional research is needed in this area.
Authors: Ema J Jamaluddin; Abdul Halim Abdul Gafor; Loo Chee Yean; Rizna Cader; Rozita Mohd; Norella C T Kong; Shamsul Azhar Shah Journal: Clin Exp Nephrol Date: 2013-08-02 Impact factor: 2.801
Authors: Anne C Beaubrun; Ryan D Kilpatrick; Janet K Freburger; Brian D Bradbury; Lily Wang; M Alan Brookhart Journal: J Am Soc Nephrol Date: 2013-06-06 Impact factor: 10.121