BACKGROUND: The purpose of this study was to test the hypothesis that decreased dietary intake of Vitamin D contributes to Vitamin D deficiency in end-stage renal disease (ESRD) patients on hemodialysis (HD). METHODS: We performed a cross-sectional study of 58 hemodialysis outpatients from two Mount Sinai Medical Center (MSMC)-affiliated outpatient HD units in New York City and 648 outpatients at MSMC with CKD stages I-IV. Serum 25(OH)D concentrations were measured from August 2010 to July of 2011 in recruited hemodialysis patients (n=58) and linked with results of dietary and lifestyle surveys. The Mount Sinai Data Warehouse (electronic medical record) was used to capture 25(OH) Vitamin D levels for outpatients with CKD stages I-IV who had Vitamin D testing during the same time period. RESULTS: The prevalence of Vitamin D insufficiency/deficiency in the HD cohort was 96.6%. Mean (SD) and median (IQR) 25(OH)D concentrations were 15.65 (6.82) and 13.55 (10.15) ng/mL, respectively. Dietary surveys showed a median weekly Vitamin D intake of 1044 IU (IQR=808, vs. a recommended weekly allowance of 4200 IU) and specific avoidance of foods containing both Vitamin D and phosphorus. In contrast, mean and median 25(OH)D concentrations in patients with CKD stages I-IV were 25.66 (13.44) and 23.60 (15.48) ng/mL (p<0.001 vs. HD patients). CONCLUSIONS: Vitamin D deficiency is more prevalent in HD patients than in pre-dialysis patients with CKD and is associated with decreased dietary intake of Vitamin D. Dialysis restrictions imposed to reduce dietary phosphorus intake likely contributes to the development of hypovitaminosis D in ESRD patients.
BACKGROUND: The purpose of this study was to test the hypothesis that decreased dietary intake of Vitamin D contributes to Vitamin D deficiency in end-stage renal disease (ESRD) patients on hemodialysis (HD). METHODS: We performed a cross-sectional study of 58 hemodialysis outpatients from two Mount Sinai Medical Center (MSMC)-affiliated outpatientHD units in New York City and 648 outpatients at MSMC with CKD stages I-IV. Serum 25(OH)D concentrations were measured from August 2010 to July of 2011 in recruited hemodialysis patients (n=58) and linked with results of dietary and lifestyle surveys. The Mount Sinai Data Warehouse (electronic medical record) was used to capture 25(OH) Vitamin D levels for outpatients with CKD stages I-IV who had Vitamin D testing during the same time period. RESULTS: The prevalence of Vitamin Dinsufficiency/deficiency in the HD cohort was 96.6%. Mean (SD) and median (IQR) 25(OH)D concentrations were 15.65 (6.82) and 13.55 (10.15) ng/mL, respectively. Dietary surveys showed a median weekly Vitamin D intake of 1044 IU (IQR=808, vs. a recommended weekly allowance of 4200 IU) and specific avoidance of foods containing both Vitamin D and phosphorus. In contrast, mean and median 25(OH)D concentrations in patients with CKD stages I-IV were 25.66 (13.44) and 23.60 (15.48) ng/mL (p<0.001 vs. HDpatients). CONCLUSIONS:Vitamin D deficiency is more prevalent in HDpatients than in pre-dialysis patients with CKD and is associated with decreased dietary intake of Vitamin D. Dialysis restrictions imposed to reduce dietary phosphorus intake likely contributes to the development of hypovitaminosis D in ESRDpatients.
Entities:
Keywords:
Hemodialysis diet; Phosphorus; Vitamin D deficiency
Authors: Christian F Helvig; Dominic Cuerrier; Christopher M Hosfield; Breanna Ireland; Aza Z Kharebov; Jae W Kim; Navindra J Ramjit; Kara Ryder; Samir P Tabash; Andrew M Herzenberg; Tina M Epps; Martin Petkovich Journal: Kidney Int Date: 2010-06-09 Impact factor: 10.612
Authors: Nazanin Noori; Csaba P Kovesdy; Ramanath Dukkipati; Usama Feroze; Miklos Z Molnar; Rachelle Bross; Allen R Nissenson; Joel D Kopple; Keith C Norris; Kamyar Kalantar-Zadeh Journal: Am J Nephrol Date: 2011-02-04 Impact factor: 3.754
Authors: Ioannis Griveas; G Visvardis; D Papadopoulou; E Mitsopoulos; P Kyriklidou; E Manou; D Meimaridou; E Ginikopoulou; G Sakellariou; A Fleva; R Zilidou; A Paulitou Journal: Ren Fail Date: 2005 Impact factor: 2.606
Authors: K Raska; J Raskova; S M Shea; R M Frankel; R H Wood; J Lifter; I Ghobrial; R P Eisinger; L Homer Journal: Am J Med Date: 1983-11 Impact factor: 4.965
Authors: Laura A G Armas; Radha Andukuri; Janet Barger-Lux; Robert P Heaney; Richard Lund Journal: Clin J Am Soc Nephrol Date: 2012-07-12 Impact factor: 8.237