Is there an association between Vitamin D level and inflammatory markers in hemodialysis patients? A cross-sectional study.

Vitamin D deficiency is very prevalent among the patients with end-stage renal disease. The etiology of this is multifactorial, including nutritional deficiency, insufficient exposure to sunlight, race, obesity and not the least, impaired Vitamin D synthesis and metabolism in chronic kidney disease patients. We hypothesized that lower Vitamin D level will be associated with higher inflammatory burden and low immunological response to hepatitis B vaccination in hemodialysis (HD) population. The study was carried out in March 2013 among 100 HD patients who were identified to be eligible for the study. This was a cross-sectional study analyzing the relationship between Vitamin D level and inflammatory markers in HD patients. A relationship between Vitamin D level and markers of mineral bone disorder was also analyzed. We also analyzed the relationship between Vitamin D level and hemoglobin and erythropoietin dosage. Hemoglobin, transferrin saturation, and erythropoietin dose were used to study the relationship between Vitamin D and markers of anemia. Antibodies to hepatitis B surface antigen were measured to study the response between Vitamin D level and immune response to hepatitis B vaccine. Vitamin D levels were significantly lower in females compared to males (P = 0.009) and diabetics compared to non-diabetics (P = 0.02). No significant association was observed between Vitamin D levels with immune response to hepatitis B vaccine (P = 0.89), C-reactive protein (P = 0.19), serum albumin (P = 0.17), hemoglobin level (P = 0.18,) and erythropoietin requirement (P = 0.87), parathyroid hormone (PTH) levels (P = 0.57), calcium levels (P = 0.79) and phosphate level (P = 0.1).