Thanh bên bài viết
Số lượt xem PDF: 53
THE ASSOCIATION BETWEEN SERUM VITAMIN D DEFICIENCY AND BONE MINERAL DENSITY IN CHRONIC KIDNEY DISEASE PATIENTS WITH REDUCED ESTIMATED GLOMERULAR FILTRATION RATE
Nội dung chính của bài viết
Tóm tắt
Background: Vitamin D deficiency is common in patients with chronic kidney disease (CKD), but its impact on bone health remains understudied. Methods: We collected data from CKD patients with eGFR < 60 mL/min/1.73m², including clinical information, 25-hydroxyvitamin D levels, and bone mineral density (BMD) measurements using DEXA between August 2020 and August 2021. Results: In a cohort of 96 patients, 63 (65.6%) were female, mean age was 62.3 ± 10.4 years, mean BMI was 22.8 ± 3.4 kg/m², and mean eGFR was 10.1 ± 7.3 ml/min. CKD staging included 13 (13.5%) in stage 3, 19 (19.8%) in stage 4, and 64 (66.7%) in stage 5, with or without dialysis. Mean serum vitamin D level was 21.3 ± 12.6 ng/ml. Hypovitaminosis D was prevalent in 74 (77.1%) cases, categorized as slight reduction in 19 (25.7%), moderate reduction in 33 (44.6%), and severe reduction in 22 (29.7%). Mean BMD at femoral neck was 0.725 ± 0.157 g/cm², and at lumbar spine, it was 0.873 ± 0.201 g/cm². Osteopenia and osteoporosis were found in 43 (44.8%) and 19 (19.8%) patients, respectively, at the femoral neck, and in 39 (40.6%) and 17 (17.7%) patients, respectively, at the lumbar spine. Statistically significant associations were observed between serum vitamin D levels and BMD at both sites: femoral neck (regression coefficient: 3.3 x 10-3, coefficient of determination: 0.09) and lumbar spine (regression coefficient: 5.1 x 10-3, coefficient of determination: 0.063). Conclusion: Vitamin D deficiency was common in CKD patients with eGFR < 60 ml/min/1.73m², and a modest but statistically significant association exists between serum vitamin D levels and BMD at both the femoral neck and lumbar spine
Chi tiết bài viết
Từ khóa
Vitamin D, bone mineral density, chronic kidney disease, reduced estimated glomerular filtration rate, eGFR
Tài liệu tham khảo
2. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2017;7(1):1-59.
3. Shroff R, Wesseling-Perry K, Bacchetta J. Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD). Pediatr Nephrol Eighth Ed. 2022:1751-1778.
4. Kim SM, Choi HJ, Lee JP, et al. Prevalence of Vitamin D Deficiency and Effects of Supplementation With Cholecalciferol in Patients With Chronic Kidney Disease. J Ren Nutr. 2014;24(1):20-25.
5. Quan H, Li B, Couris CM, et al. Updating and validating the charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173(6):676-682.
6. Rozita M, Afidza MN, Ruslinda M, et al. Serum Vitamin D levels in patients with chronic kidney disease. EXCLI J. 2013;12:511-520.
7. Satirapoj B, Limwannata P, Chaiprasert A, Supasyndh O, Choovichian P. Vitamin D insufficiency and deficiency with stages of chronic kidney disease in an Asian population. BMC Nephrol. 2013;14(1).
8. Nguyễn Hữu Vũ Quang. Nghiên cứu nồng độ FGF-23 huyết thanh và mối liên quan với một số rối loạn khoáng xương ở bệnh nhân bệnh thận mạn. Đại học Y dược – Đại học Huế. 2020; 1-119.
9. Lữ Công Trung và cs. Tìm hiểu một số yếu tố liên quan đến giảm Vitamin D và cường cận giáp thứ phát ở bệnh nhân suy thận mạn lọc máu. Tạp chí Y học Thành phố Hồ Chí Minh. 2019;21:1-7.
10. Alwakeel JS, Usama S, Mitwalli AH, Alsuwaida A, Alghonaim M. Prevalence of vitamin D deficiency in peritoneal dialysis patients. Saudi J Kidney Dis Transpl. 2014;25(5):981-985.
11. Denburg MR, Tsampalieros AK, De Boer IH, et al. Mineral metabolism and cortical volumetric bone mineral density in childhood chronic kidney disease. J Clin Endocrinol Metab. 2013;98(5):1930-1938.
12. Kim MK, Baek KH, Song KH, et al. Vitamin D deficiency is associated with sarcopenia in older Koreans, regardless of obesity: The fourth Korea National Health and Nutrition Examination Surveys (KNHANES IV) 2009. J Clin Endocrinol Metab. 2011;96(10):3250-3256.
13. Mucsi I, Almási C, Deák G, et al. Serum 25(OH)-vitamin D levels and bone metabolism in patients on maintenance hemodialysis. Comp Study. 2005;64(4):288-294.
14. Ivo Valkovsky, Olsanska R, Tvrdik J, et al. Evaluation of biochemical markers and bone mineral density in patients with chronic kidney disease stage 5D at the start of hemodialysis treatment. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015;159(1):93-99.
15. Coen G, Mantella D, Manni M, et al. 25-hydroxyvitamin D levels and bone histomorphometry in hemodialysis renal osteodystrophy. Kidney Int. 2005;68(4):1840-1848.