Changes in 25-hydroxy-vitamin D3 level and relevant factors in chronic kidney disease
Objective To measure the plasma level of 25-hydroxy-vitamin D3[25(OH)D3]in non-dialysis patients with chronic kidney disease(CKD) at different stages,and to investigate the correlations between the levels of 25(OH)D3 and the progression of CKD.Furthermore,we explored the effective application of act...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Department of Journal of Clinical Nephrology
2016-01-01
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| Series: | Linchuang shenzangbing zazhi |
| Subjects: | |
| Online Access: | http://www.lcszb.com/thesisDetails?columnId=57918560&Fpath=home&index=0 |
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| Summary: | Objective To measure the plasma level of 25-hydroxy-vitamin D3[25(OH)D3]in non-dialysis patients with chronic kidney disease(CKD) at different stages,and to investigate the correlations between the levels of 25(OH)D3 and the progression of CKD.Furthermore,we explored the effective application of active vitamin D in CKD.Methods We included 885 non-dialysis CKD patients and 11 patients with acute kidney disease(AKI) hospitalized in the Department of Nephrology in the First Affiliated Hospital of China Medical University from Nov.2014 to Nov.2015.Serum 25(OH)D3 levels and other clinical parameters were detected.We further analyzed the prevalence rate of vitamin D insufficiency and deficiency at different stages of CKD,the trend of other relevant biochemical parameters at various groups of vitamin D level,and the correlations between 25(OH) D3 level and the factors.Results(1) With the progression of kidney disease,remarkable increasing trend was found in prevalence rate of vitamin D severe deficiency..The 25(OH) D3 concentration in AKI was(15.8 ±9.16) ng/mL,which was significantly higher than that of each stages of CKD(P<0.05).With the decrease of 25(OH) D3 concentration,the level of blood pressure(systolic pressure and diastolic pressure) increased,proteinuria deteriorated,the level of serum albumin decreased,calciumphosphorus metabolic disorder(blood calcium decreased,blood phosphorus elevated) and lipid metabolic abnormality aggravated.The differences in 25(OH) D3 levels among the groups were statistically significant(P<0.05).But age,left ventricular ejection fraction,the kidney function indexes,bone metabolism indexes,serum uric acid,hemoglobin and C-ractive protein were not statistically significant(P>0.05).(2) 25(OH) D3 levels were correlated with proteinuria.The concentrations of 25(OH) D3 in moderate proteinuria group and massive proteinuria group were remarkably lower than those in micro-proteinuria group and normal group- respectively(P<C0.05).Remarkable distinction was.found in prevalence rate of vitamin D severe deficiency at various groups,and higher prevalence rate tended to favor more advanced proteinuria group.The discrepancies in deficiency prevalence were statistically significant(χ~2 = 251.75,P= 0.000).(3) Pearson’s correlation analyses revealed that serum albumin,calcium and hemoglobin were positively correlated with serum 25(OH) D3,whereas systolic pressure,diastolic pressure,24-h urine protein,serum phosphorous and blood lipids(TC,TG,LDL-C,and HDL-C) were negatively correlated with 25(OH) D3.Multiple linear regression analyses demonstrated that serum albumin,systolic pressure,24-h urine protein and hemoglobin were the independent risk factors of vitamin D deficiency in non-dialysis CKD patients.Conclusions In the northeast of China,vitamin D deficiency in non-dialysis CKD patients was frequent and serious.The change in 25(OH) D3 concentration was correlated with the clinical parameters of CKD.Serum albumin,systolic pressure,24-h urine protein and hemoglobin were the independent risk factors of vitamin D deficiency. |
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| ISSN: | 1671-2390 |