PREVALENCE OF VITAMIN D DEFICIENCY AND INSUFFICIENCY IN FILIPINO PATIENTS WITH CHRONIC KIDNEY DISEASE ON HEMODIALYSIS: A HOSPITAL-BASED CROSS-SECTIONAL STUDY

 

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https://storage.unitedwebnetwork.com/files/1099/0345beeaac1b6466e51ca0a2d9750546.pdf
PREVALENCE OF VITAMIN D DEFICIENCY AND INSUFFICIENCY IN FILIPINO PATIENTS WITH CHRONIC KIDNEY DISEASE ON HEMODIALYSIS: A HOSPITAL-BASED CROSS-SECTIONAL STUDY

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DACUDAO
KAREN
DACUDAO KAREN dirockz123@gmail.com Maria Reyna - Xavier University Hospital, Inc Department of Internal Medicine Cagayan de Oro Philippines *
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Vitamin D deficiency is highly prevalent in patients with Chronic Kidney Disease (CKD), yet local data from the Philippines are limited. While 25-hydroxyvitamin D levels are not routinely measured in End-Stage Renal Disease (ESRD) due to cost, evidence suggests a 50%-90% deficiency rate in this population. This study aimed to determine the prevalence of vitamin D deficiency and insufficiency in CKD patients on hemodialysis at our institution and identify associated risk factors and comorbidities.

This prospective, hospital-based cross-sectional study was conducted from December 1, 2013, to November 30, 2014. We analyzed data from 23 adult CKD Stage 5 patients on maintenance hemodialysis for over one month. Blood samples were collected for 25-hydroxyvitamin D (25(OH)D3) and intact parathyroid hormone (iPTH), alongside routine labs. Vitamin D levels were classified as sufficient (≥30 ng/mL), insufficient (20-29 ng/mL), deficient (<20 ng/mL), and severely deficient (<10 ng/mL). Statistical analysis included Kruskal-Wallis One-way ANOVA and Pearson Chi-Square for subgroup differences and Point Biserial Correlation and Cramer's V for associations with variables such as age, gender, weight, dialysis duration and frequency, CKD etiology, albumin, creatinine, ionized calcium, phosphorus, 1,25 (OH)2 D3, iPTH, antihypertensive medications, and other supplements.

Among the 23 patients, 30.4% (n=7) were vitamin D sufficient, 26.1% (n=6) were insufficient, 30.4% (n=7) were deficient, and 13.0% (n=3) were severely deficient. Overall, 43.4% (n=10) exhibited vitamin D deficiency (including severe deficiency). A significant difference was observed in mean serum creatinine and vitamin D levels across vitamin D classifications (p < 0.05). Age was significantly associated with vitamin D sufficiency, with older patients more likely to be deficient. Gender did not show a statistically significant influence on vitamin D classification. Risk factors significantly associated with vitamin D deficiency/insufficiency included aspirin, sevelamer, and age. Furthermore, steroid use was associated with severe vitamin D deficiency. Regarding comorbidities, diabetic nephropathy significantly contributed to vitamin D insufficiency, while hypertensive nephrosclerosis was a significant contributor to vitamin D deficiency.

Vitamin D deficiency and insufficiency are highly prevalent among Filipino CKD patients on hemodialysis. Key factors associated with these vitamin D levels were aspirin, sevelamer, steroid use, and patient age. Diabetic nephropathy and hypertensive nephrosclerosis were significant contributing to comorbidities. These findings underscore the need for targeted interventions and further research into this population.

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