Ravi Arulanantham1, Suresh Mariappan2, Shankar Radhakrishnan3
Vitamin D deficiency is highly prevalent among patients with chronic kidney disease (CKD). Accumulating evidence indicates the associations of vitamin D deficiency with morbidities and mortality in patients with CKD. The recent Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guidelines for Bone Mineral Metabolism and Disease in Chronic Kidney Disease had recommended the measurements of 25-hydroxyvitamin D levels in patients with CKD who are not on dialysis. Little is known about the magnitude of vitamin D deficiency in patients with CKD living in rural South India.
To assess the prevalence of vitamin D deficiency among the patients with chronic kidney disease.
The prevalence of 25-hydroxyvitamin D3 (25OHD) deficiency (defined as a level <20 ng/ml) were examined in 100 patients with CKD. Patients on dialysis and those receiving medication known to influence vitamin D, were excluded. CKD was diagnosed based on history, clinical features, USG abdomen and renal function test and eGFR. We examined the levels of 25OHD in 100 patients with CKD stages 3 and 4. Patients were investigated for hemogram, renal function tests, serum vitamin D level, fasting blood sugar and ECG.
The overall prevalence of vitamin D deficiency among the CRF patients in our study was 69% and the insufficiency was present in 17% of the CRF patients and only 14% of the study subjects had normal vitamin D levels. Among the various factor influencing the prevalence of vitamin D deficiency in CRF patients, diabetes and hypertension are the most important factors. In our study the mean levels of vitamin D was much lower in patients with diabetes and hypertension when compared to patients without diabetes and hypertension and the difference was found to be statistically significant (p=0.003).
Our study concluded that vitamin D deficiency is highly prevalent among CKD patients. Diabetes and hypertension are the most important influencing factors in the development of hypovitaminosis D among the chronic renal failure patients.