25-Hydroxyvitamin D Status Based on Estimated Glomerular Filtration Rate in Patients with Chronic Kidney Disease.
- Author:
Jung Hee KOH
1
;
Ihm Soo KWAK
;
Sang Heon SONG
;
Soo Bong LEE
;
Harin RHEE
;
Eun Young SEONG
;
Chang Jun PARK
;
Tae Kyun KIM
;
Sang Bo OH
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. iskwak@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Renal insufficiency, Chronic;
Vitamin D;
Parathyroid hormone
- MeSH:
Cholesterol;
Cohort Studies;
Glomerular Filtration Rate;
Humans;
Korea;
Lipoproteins;
Parathyroid Hormone;
Renal Insufficiency, Chronic;
Retrospective Studies;
Risk Factors;
Seasons;
Vitamin D;
Vitamin D Deficiency
- From:Korean Journal of Medicine
2012;83(6):740-751
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Accumulating data suggest that vitamin D deficiency is prevalent in patients with chronic kidney disease (CKD). However, comprehensive data are lacking for Koreans. The aim of this study was to survey vitamin D deficiency among patients with CKD in Korea and to identify the relationships among various factors. METHODS: We conducted a retrospective cohort study of 444 patients who were divided into four subgroups by estimated glomerular filtration rate (eGFR) for comparisons of mean 25-hydroxyvitamin D [25(OH)D] level and other parameters. In addition, non-dialyzed patients were categorized into four groups based on 25(OH)D levels (<10, 10-19, 20-29, and > or =30 ng/mL), and risk factors for severe vitamin D deficiency (<10 ng/mL) were investigated. RESULTS: Of patients with an eGFR > or = 60 mL/min/1.73 m2, 43% (34/79) showed severe 25(OH)D deficiency, and the mean 25(OH)D level was 11.7 +/- 5.3 ng/mL. In CKD3 group, 53.2% (41/77) showed severe 25(OH)D deficiency, with a mean level of 11.3 +/- 7.2 ng/mL. In CKD4 group, 53.3% (49/92) had severe 25(OH)D deficiency, with a mean level of 11.0 +/- 6.2 ng/mL. Approximately 71% (139/196) of patients in CKD5 group showed severe deficiency, and the mean level was 9.2 +/- 5.9 ng/mL. Severe 25(OH)D deficiency was affected by winter season, renal function, diabetes, and low-density lipoprotein cholesterol. The serum parathyroid hormone level was inversely correlated with the 25(OH)D level, such that 25(OH)D <20 ng/mL were associated with a steep increase in parathyroid hormone. CONCLUSIONS: Vitamin D deficiency is highly prevalent in the Korean population. Few patients met a sufficient 25(OH)D concentration, even in the early stages of CKD. Our data suggest that 25(OH)D level of 20 ng/mL is a threshold for a rapid increase in parathyroid hormone levels.
