PREVALENCE AND FACTORS ASSOCIATED WITH VITAMIN D DEFICIENCY AMONG DIALYSIS-REQUIRING PATIENTS

 

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PREVALENCE AND FACTORS ASSOCIATED WITH VITAMIN D DEFICIENCY AMONG DIALYSIS-REQUIRING PATIENTS

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Vitamin D deficiency is a global health concern, with its prevalence reaching alarming rates among patients with chronic kidney disease (CKD), particularly those requiring dialysis. It ranges from 50-98% among hemodialysis patients and even higher at 86-100% for those on peritoneal dialysis. It is considered a mortality risk factor, however, the pathophysiology is still unclear. This study aimed to determine the local prevalence and factors associated with Vitamin D deficiency among dialysis patients.

A cross-sectional study was conducted wherein all end-stage renal disease (ESRD) patients aged >19years old and on maintenance dialysis >3months were included. The mean Vitamin D, intact parathyroid hormone, ionized calcium, phosphorus, alkaline phosphatase and hematocrit were recorded. Correlation of age, gender, pre-dialysis co-morbidities, dialysis vintage and frequency were determined using spearman rank correlation coefficient, chi-square test and regression analysis with odds ratio.

A total of 240 chronic dialysis patients in our unit were identified. Out of the 240 patients, 168 patients were included. The patients were distributed into Vitamin D sufficient and insufficient/deficient group. The prevalence rate of Vitamin D insufficiency and deficiency is low at 11.9% and 6%, respectively. Low hematocrit (p=0.032) and high alkaline phosphatase levels (p=0.022) were considered statistically significant among Vitamin D insufficient/deficient group. Thrice a week dialysis is positively correlated with Vitamin D levels (r= 27.995, p=<0.01, 95% CI -0.245, 1.705). Patients, either on hemodialysis or peritoneal dialysis, have significantly increased Vitamin D levels by 104.64 ng/mL (p=0.0016).

The low prevalence of Vitamin D insufficiency/deficiency establishes the evidence that this disease condition is not universally observed among dialysis-requiring patients.  Patients, either on hemodialysis or peritoneal dialysis, shows a significant increase in Vitamin D levels by 104.64ng/mL (p=0.0016). Thrice a week dialysis is positively correlated with Vitamin D levels (r= 27.995, p=<0.01, 95% CI -0.245, 1.705). Medication use among these patients affects their serum Vitamin D levels.

Kewords