Prevalence of Vitamin D deficiency and associated risk factors in dialysis population

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https://storage.unitedwebnetwork.com/files/1099/94176f3ce3ae4e19f50b5f04ca8cf002.pdf

Abstract Title

First Name *

Imed

Last Name *

Helal

Co-author 1

Ayman Fadlallah Ayman.Fadlallah@diaverum.com Faculty of Medicine Ain Shams University Internal Medicine and Nephrology Department Cairo

Co-author 2

Mohammed Alhomrany Mohammed.Alhomrany@diaverum.com Diaverum Holding AB Branch Medical Department Riyadh

Co-author 3

Alkhateeb Alkemary Alkhateeb.Alkemary@diaverum.com Cairo university internal medicine and Nephrology Cairo

Co-author 4

Fayez Alhejaili Fayez.Alhejaili@diaverum.com Diaverum Holding AB Branch Medical Department Riyadh

Co-author 5

Dujanah Mousa Dujanah.Mousa@diaverum.com Diaverum Holding AB Branch Medical Department Riyadh

Co-author 6

Ali Alharbi Ali.Alharbi@diaverum.com Diaverum Holding AB Branch Medical Department Riyadh

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Vitamin D deficiency is the most common medical condition in dialysis population worldwide. This study aim to determine the vitamin D status and associated risk factors in large Saudi dialysis patients.

Methods

This is a cross sectional observational study enrolled 3742 patients on chronic dialysis. The chemiluminescent microparticle immunoassay is used for the quantitative determination of 25 –OH Vitamin D. Blood samples for 25(OH) D levels were obtained pre-dialysis during the month of May. Vitamin D stores were considered adequate when serum 25(OH) D levels were above 30 ng/ml. Levels between 16 and 30 ng/ml were considered as vitamin D insufficiency, and vitamin D deficiency was defined as values below or equal to15 ng/ml.

Results

Of the 3742 patients, 2156 (54.7%) were males and 1586 (42.4%) were females with a mean age54.27 ± 16.11 years. The baseline median 25-OH vitamin D level of the cohort was 17.8±12.5 ng/ml. 1711(45.7%) were vit D deficient, 1683 (45%) were vit D insufficient and only 348 (9.3%) had normal vit D levels. Vit-D deficient patients were younger than the patients who had Vit D insufficient and normal Vit-D levels(p=0.002). In addition, Vit-D deficient patients had significantly higher BMI (p = 0.004), longer dialysis duration(p<0.0001), low level of hemoglobin (p=0.028), low albumin (p<0.0001), high phosphorus (p<0.0001), and high iPTH (p=0.01). The risk estimate calculated Odds Ratios for vitamin D deficiency demonstrate that diabetes 1.087 [95% CI,1018-1.160] (p<0.001), lower albumin (≤35.5g/l) 1.363 [95% CI, 1.227-1.514] (p<0.001), higher calcium phosphorus product 1.516 [95 CI, 1.194-1.924] (p<0.001), female gender 1.457 [95CI, 1.352-1571] (p<0.001),high flux hemodialysis vs on-line hemodiafiltration modality 1.054 [95CI, 1.006-1.104] (p<0.001), BMI more than 30 kg/m 1.143 [95CI, 1.036-1.261] (p<0.001) and higher PTH 1.510 [95CI,1.262-1.806] (p<0.001) were at a higher risk of having vitamin D deficiency.

Conclusions

These results indicate that vitamin D deficiency is highly prevalent even in dialysis patients living in sunny country. Vitamin D deficiency appears to be related to female gender, increased BMI, diabetes, lower albumin, higher calcium phosphorus product and higher iPTH.

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