The Prevalence of Vitamin D Insufficiency and Deficiency with Stages of Chronic Kidney Disease in Phra Nakhon Si Ayutthaya Population
Keywords:
vitamin D insufficiency and deficiency, chronic kidney disease, Phra Nakhon Si AyutthayaAbstract
Vitamin D insufficiency and deficiency are associated with proteinuria, moreover, both conditions are not only risk factors for end-stage renal disease (ESRD) but also the risk factor of death in patients with chronic kidney disease (CKD). A previous study has shown that 25-hydroxyvitamin D insufficiency and deficiency are more common and associated with the level of kidney function in CKD population. However, no study has examined the prevalence
of vitamin D insufficiency and deficiency of CKD in Phra Nakhon Si Ayutthaya population. The objective of this study was to identify the prevalence of vitamin D insufficiency and deficiency with stages of CKD in Phra Nakhon Si Ayutthaya population. A cross-sectional study was carried out in 476 CKD patients who followed up at the CKD-outpatient clinic in Phra Nakhon Si Ayutthaya Hospital between January 1, 2016 and December 31, 2016 and had their 25-hydroxyvitamin D level assessed. Serum levels of 25-hydroxyvitamin D were analyzed according to CKD stages. Vitamin D deficiency and insufficiency were defined as a serum 25-hydroxyvitamin D concentration < 20 ng/mL and 20-29 ng/mL, respectively. The mean (SD) 25-hydroxyvitamin D levels were significantly lower according to severity of renal impairment (CKD stage 3a: 26.7 11.0 ng/mL, CKD stage 3b: 29.0
12.0 ng/mL, CKD stage 4: 22.0
13.0 ng/mL, CKD stage 5: 14.6
8.7 ng/mL, p<0.001). The prevalence of vitamin D deficiency and insufficiency of CKD stage 3a, 3b, 4 to 5 was 72.7%, 59.0%, 71.9%, 94.6%, respectively (p<0.001). The odds ratio (95%CI) of vitamin D deficiency and insufficiency (serum 25-hydroxyvitamin D < 30 ng/mL) and only vitamin D deficiency (serum 25-hydroxyvitamin D < 20 ng/mL) for developing ESRD, after adjustment for age, gender, haemoglobin, serum albumin, calcium, phosphate were 7.81 (95%CI 4.28 to 14.25) and 11.07 (95%CI 5.94 to 20.5), respectively. This study demonstrated that 25-hydroxyvitamin D insufficiency and deficiency were more common and associated with the level of kidney function in The Phra Nakhon Si Ayutthaya CKD population especially advance stage of CKD.
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