25-Hydroxyvitamin D levels in prevalent Australian dialysis patients. 2009

Philip Clayton, and Richard Singer
Department of Renal Medicine, The Canberra Hospital, Canberra, Australia.

OBJECTIVE Vitamin D deficiency is a common problem in the general population. A high frequency of vitamin D deficiency in the pre-dialysis and dialysis populations has been observed overseas, but there is limited information regarding vitamin D levels in Australian dialysis patients. METHODS We measured 25-hydroxyvitamin D levels in 120 haemodialysis (HD) and 31 peritoneal dialysis (PD) patients. We defined vitamin D deficiency as a level <50 nmol/L and insufficiency as a level of 50-74 nmol/L. We assessed for correlation between vitamin D levels and markers of bone and mineral metabolism, age, sex, dialysis type, dialysis duration, haemoglobin and erythropoietin dose. RESULTS Of the HD patients, 59 (49%) were frankly deficient and 39 (33%) had insufficiency. Of the PD patients, 24 (77%) were frankly deficient and 6 (19%) had insufficiency. Overall, only 23 patients (19%) had sufficient levels of vitamin D. Vitamin D levels were significantly lower in PD patients (P = 0.001), in females (P = 0.002) and in those with diabetic nephropathy (P = 0.03). There was no correlation between vitamin D levels and markers of bone and mineral metabolism, age, dialysis duration, haemoglobin or erythropoietin dose. CONCLUSIONS Vitamin D deficiency and insufficiency were very common in this cohort of prevalent Australian dialysis patients. Lower levels were associated with PD as treatment modality, female sex and diabetic nephropathy.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010530 Peritoneal Dialysis Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. Dialyses, Peritoneal,Dialysis, Peritoneal,Peritoneal Dialyses
D005260 Female Females
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D014807 Vitamin D A vitamin that includes both CHOLECALCIFEROLS and ERGOCALCIFEROLS, which have the common effect of preventing or curing RICKETS in animals. It can also be viewed as a hormone since it can be formed in SKIN by action of ULTRAVIOLET RAYS upon the precursors, 7-dehydrocholesterol and ERGOSTEROL, and acts on VITAMIN D RECEPTORS to regulate CALCIUM in opposition to PARATHYROID HORMONE.
D014808 Vitamin D Deficiency A nutritional condition produced by a deficiency of VITAMIN D in the diet, insufficient production of vitamin D in the skin, inadequate absorption of vitamin D from the diet, or abnormal conversion of vitamin D to its bioactive metabolites. It is manifested clinically as RICKETS in children and OSTEOMALACIA in adults. (From Cecil Textbook of Medicine, 19th ed, p1406) Deficiency, Vitamin D,Deficiencies, Vitamin D,Vitamin D Deficiencies

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