Nipith Charoenngam1, Sutin Sriussadaporn2. 1. Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand. 2. Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand. sutin.sri@mahidol.ac.th.
Abstract
INTRODUCTION: Evidence on vitamin D and parathyroid hormone (PTH) status in patients with early kidney impairment is limited. We aimed to determine the associations among kidney function, vitamin D, and PTH status in community-dwelling elderly patients with mild-to-moderate kidney impairment. METHODS: Community-dwelling elderly patients were enrolled in this Institutional Review Board approved cross-sectional study. The eligibility criteria were as follows: age > 60 years, no recent hospitalization within the past 12 months, no conditions that affect vitamin D status including vitamin D supplementation, and eGFR > 30 mL/min/1.73 m2. Serum 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) levels were assessed. RESULTS: A total of 226 patients were enrolled. Data were expressed as mean ± SD. The mean serum 25(OH)D was 26.61 ± 10.44 ng/mL and the mean serum PTH was 50.67 ± 22.67 pg/mL. The prevalence of vitamin D deficiency [25(OH)D < 20 ng/mL] and secondary hyperparathyroidism [PTH > 65 pg/mL] were 25.3% and 18.1%, respectively. Patients with eGFR 30- < 60 mL/min/1.73m2 had significantly higher prevalence of 25(OH)D < 20 ng/mL (33.7% versus 19.4%, p < 0.05) than patients with eGFR ≥ 60 mL/min/1.73 m2. Multiple regression analysis showed independent negative association of serum PTH level with eGFR (mL/min/1.73 m2, β: - 0.261, 95% CI [- 0.408, - 0.114]) and serum 25(OH)D (ng/mL, β: - 0.499, 95% CI [- 0.775, - 0.223], adjusted for possible confounders). CONCLUSIONS: The prevalence of vitamin D deficiency was higher in patients with eGFR 30 - < 60 mL/min/1.73 m2 than those with eGFR ≥ 60 mL/min/1.73 m2. Both decreased serum 25(OH)D levels and decreased eGFR were independently associated with increased serum PTH levels among these patients.
INTRODUCTION: Evidence on vitamin D and parathyroid hormone (PTH) status in patients with early kidney impairment is limited. We aimed to determine the associations among kidney function, vitamin D, and PTH status in community-dwelling elderly patients with mild-to-moderate kidney impairment. METHODS: Community-dwelling elderly patients were enrolled in this Institutional Review Board approved cross-sectional study. The eligibility criteria were as follows: age > 60 years, no recent hospitalization within the past 12 months, no conditions that affect vitamin D status including vitamin D supplementation, and eGFR > 30 mL/min/1.73 m2. Serum 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) levels were assessed. RESULTS: A total of 226 patients were enrolled. Data were expressed as mean ± SD. The mean serum 25(OH)D was 26.61 ± 10.44 ng/mL and the mean serum PTH was 50.67 ± 22.67 pg/mL. The prevalence of vitamin D deficiency [25(OH)D < 20 ng/mL] and secondary hyperparathyroidism [PTH > 65 pg/mL] were 25.3% and 18.1%, respectively. Patients with eGFR 30- < 60 mL/min/1.73m2 had significantly higher prevalence of 25(OH)D < 20 ng/mL (33.7% versus 19.4%, p < 0.05) than patients with eGFR ≥ 60 mL/min/1.73 m2. Multiple regression analysis showed independent negative association of serum PTH level with eGFR (mL/min/1.73 m2, β: - 0.261, 95% CI [- 0.408, - 0.114]) and serum 25(OH)D (ng/mL, β: - 0.499, 95% CI [- 0.775, - 0.223], adjusted for possible confounders). CONCLUSIONS: The prevalence of vitamin D deficiency was higher in patients with eGFR 30 - < 60 mL/min/1.73 m2 than those with eGFR ≥ 60 mL/min/1.73 m2. Both decreased serum 25(OH)D levels and decreased eGFR were independently associated with increased serum PTH levels among these patients.
Entities:
Keywords:
25-Hydroxyvitamin D; Chronic kidney disease; Vitamin D
Authors: E Ishimura; Y Nishizawa; M Inaba; N Matsumoto; M Emoto; T Kawagishi; S Shoji; S Okuno; M Kim; T Miki; H Morii Journal: Kidney Int Date: 1999-03 Impact factor: 10.612
Authors: M Wolf; A Shah; O Gutierrez; E Ankers; M Monroy; H Tamez; D Steele; Y Chang; C A Camargo; M Tonelli; R Thadhani Journal: Kidney Int Date: 2007-08-08 Impact factor: 10.612