ภาวะขาดวิตามินดีในผู้ป่วยโรคไตเรื้อรังระยะท้าย

Abstract

Background: Vitamin D deficiency is an emerging global health problem. As such, vitamin D deficiency has various adverse consequences, including detrimental impact on the renal and cardiovascular system. Prevalence of vitamin D deficiency in patients with chronic kidney disease (CKD) varies in different countries. Therefore, the current study was designed to assess vitamin D status in CKD patients in Thailand.

Methods: This cross-sectional study was performed in 101 patients with CKD.  Patients were divided into three groups according to levels of estimated glomerular filtration rate (GFR): group 1; GFR 15-29 mL/min/1.73 m², group 2; GFR 30-44 mL/min/1.73 m², and group 3; GFR 45-59 mL/min/1.73 m². Serum 25-hydroxyvitamin D (25(OH) D) was measured by Chemiluminescent Microparticle Immunoassay (CMIA).

Results: The mean age of subjects was 71.04±9.35 years. The mean 25(OH) D level was 24.49±8.31 ng/mL and the prevalence of vitamin D insufficiency was 82.2 %. The group 1 had higher prevalence of vitamin D insufficiency than the group 2 (group; 1 93.3% vs. group 2; 76.9%, P=0.04). Systolic blood pressure (r= -0.267, p=0.007), diastolic blood pressure (r= -0.232, p=0.020), fasting plasma glucose (r= -0.281, p=0.005) and hemoglobin A1C (r= -0.268, p=0.007) were negative correlated with serum 25(OH) D concentrations. 

Conclusion: This study indicates that vitamin D insufficiency is an extremely frequent condition in patients with CKD, especially in those with an estimated GFR of less than 30 mL/min/1.73 m². In addition, there is a decrease in the concentration of serum 25(OH) D with increase blood pressure and blood glucose.