Vitamin D deficiency in patients with stages 1 and 2 chronic kidney disease in Southern China

Abstract

Aim: We aim to investigate the incidence and associated factors of vitamin D deficiency, a seldom reported factor, in patients with stages 1 and 2 chronic kidney disease (CKD) in southern China.

Methods: We conducted a single‑center observational study. Hospitalized patients over 14 years old, who were diagnosed with stages 1 and 2 CKD and had their serum 25‑hydroxyvitamin D [25 (OH) D] measured, were included. Patients were divided into vitamin D deficient and non‑deficient groups depending on the cutoff serum 25 (OH) D value of 37 nmol/L. Clinical and biochemical parameters were evaluated for associated factors of vitamin D deficiency by logistic regression.

Results: A total of 118 patients were included, of which 62 (52.5%) were vitamin D insufficient and 47 (39.8%) were vitamin D deficient. Using multivariate binary logistic regression analysis, high serum level of gamma‑glutamyl transpeptidase (GGT) (OR = 5.163; 95%CI, 1.105‑24.130; P = 0.037), dyslipidemia (OR = 3.083; 95%CI, 1.029‑9.243; P = 0.044), 24‑hour urinary protein excretion (UPE) ≥3.5 g/24 hrs (OR = 5.010; 95%CI, 1.316‑19.074; P = 0.018), and treatment with glucocorticoids (OR = 2.973; 95%CI, 1.093‑8.084; P = 0.033) were independently associated with vitamin D deficiency. In addition, among different types of nephropathy, minimal change disease (MCD) had the highest incidence (85.7%) of vitamin D deficiency.

Conclusion: Poor vitamin D status is common in patients with stages 1 and 2 CKD in southern China. The incidence of vitamin D deficiency is 39.8%. High serum GGT level, dyslipidemia, 24‑hour UPE ≥3.5 g/24 hrs, and treatment with glucocorticoids are independent associated factors of vitamin D deficiency.

Keywords: 25‑hydroxyvitamin D, chronic kidney disease, vitamin D deficiency