ASSOCIATION OF LOW SERUM 25-HYDROXYVITAMIN D WITH ARTERIAL STIFFNESS IN NON-DIALYSIS CKD (STAGE 3-5).

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ASSOCIATION OF LOW SERUM 25-HYDROXYVITAMIN D WITH ARTERIAL STIFFNESS IN NON-DIALYSIS CKD (STAGE 3-5).

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Co-author 1

MD. NAZRUL ISLAM nazrul.rita@gmail.com DHAKA MEDICAL COLLEGE NEPHROLOGY DHAKA Bangladesh *

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Introduction

Arterial stiffness refers to arterial wall rigidity. Arterial stiffness increases in early stage chronic kidney disease (CKD), and it is a strong predictor of cardiovascular and all-cause of mortality. 25-hydroxyvitamin D 25(OH)D deficiency is quite common worldwide and in the CKD population. It has beneficial effects on blood pressure, vascular endothelial function and arterial stiffness. Research works have indicated that serum 25(OH)D is significantly lower in participants with a severe decrease in estimated glomerular filtration rate (eGFR) compared with those with normal kidney function. In addition, impaired vitamin D status, characterized by low serum 25 (OH) D levels, is independently associated with a higher prevalence of cardiovascular disease. It is worth noting that there is limited data with regard to whether vitamin D deficiency plays an important role in arterial stiffness in patients with non-dialysis-dependent CKD especially in our country.

Methods

This hospital based cross sectional observational study was conducted at the Department of Nephrology in Dhaka Medical College from September 2021 to March 2023. A total 100 non dialytic CKD (Stage 3-5) patients were enrolled according to selection criteria. Patients were divided into two groups according to the serum 25(OH)Vitamin D status. The pulse wave velocity (PWV) was measured by Doppler USG. Following completion of the data collection, data analysis was done using SPSS version 26.

Results

The mean age was 55.35±16.79 years in Vitamin-D deficient and 43.06±16.44 years in Vitamin-D non deficient. More than half (56.0% of patients were male in Vitamin-D deficient and 26 (52.0%) in Vitamin-D non deficient group. The mean systolic BP was 150.96±29.37 mmHg in Vitamin-D deficient and 132.13±33.16 mmHg in Vitamin-D non deficient. The mean diastolic BP was 92.5±13.2 mmHg in Vitamin-D deficient and 81.67±13.42 mmHg in Vitamin-D non deficient. The mean BMI (kg/m2) 22±3 in Vitamin-D deficient and 24±2 mmHg in Vitamin-D non deficient group. The mean e GFR was 12.53±6.3 in Vitamin-D deficient and 29.42±14.07 in Vitamin-D non deficient group. The mean Hb % was 10.2±2.4 in Vitamin-D deficient and 11.1±3.2 in Vitamin-D non deficient group. Multiple linear regression analysis: independent predictors of brachial ankle pulse wave velocity (baPWV) in non dialysis CKD. It was observed that Vit-D, age and S.iPTH were independent significant predictors of brachial ankle pulse wave velocity . Others were not significantly associated with brachial ankle pulse wave velocity (baPWV). The mean brachial ankle pulse wave velocity was 22.5±1.75 m/s in Vitamin-D deficient and 16.86±1.82 m/s in Vitamin-D non deficient. The differences of brachial ankle pulse wave velocity in stage 3A, 3B, 4 and 5 were statistically significant (p<0.05) between Vitamin-D deficient and non deficient .The differences of brachial ankle pulse wave velocity in demographic variables (age, sex and smoking status) were statistically significant (p<0.05) between Vitamin-D deficient and non deficient.

Conclusion

The study revealed the high prevalence of 25(OH)D deficiency in CKD patients. 25(OH)D deficiency is a contributing factor in the development of arterial stiffness in CKD

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