Vitamin D Level in Predialysis Chronic Kidney Disease Patients Stage 3 to 5 and Predictors of its Deficiency
Mohamed G. Mohamed *
Internal Medicine Department, Faculty of Medicine, Tanta University, Egypt.
Hanaa I. Okda
Internal Medicine Department, Faculty of Medicine, Tanta University, Egypt.
Hossam A. Hodeib
Clinical Pathology Department, Faculty of Medicine, Tanta University, Egypt.
Mostafa T. Gabr
Internal Medicine Department, Faculty of Medicine, Tanta University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Vitamin D deficiency is commonly encountered in patients with chronic kidney disease (CKD) with or without undergoing dialysis. This study was conducted to assess vitamin D level in patients diagnosed with predialysis CKD stage 3 – 5, and to determine the predictors of its deficiency in such patients.
Materials and Methods: This cross-sectional study included 75 patients who were divided into three equal groups of CKD-3, CKD-4 and CKD-5. All cases were subjected to detailed history taking, physical examination and measurement of estimated glomerular filtration rate (eGFR) according to Cockcroft-Gault formula. In addition, laboratory investigations included CBC, renal function tests, serum ferritin, intact parathyroid hormone (iPTH) and vitamin D level.
Results: Patient demographics and other co-morbidities were comparable among the three groups. Serum vitamin D had mean values of 24.84, 20.52 and 11.24 ng/ml in patients with stages III, IV and V respectively, with significant difference between the three groups. Vitamin D deficiency was more common in CKD-5 cases. On the contrary, serum parathyroid hormone and ferritin were significantly higher levels, in patients with higher stages. There was statistically significant positive correlation of serumvitamin D with eGFR, Hb, calcium and albumin. On the other hand, serum vitamin D was negatively correlated with phosphate, PTH, urea andcreatinine.
Conclusion: It is evident that higher stages of CKD are associated with more vitamin D deficiency.
Keywords: Vitamin D, chronic kidney disease, predailysis