title: Hypovitaminosis D is associated with systemic inflammation and concentric myocardial geometric pattern in hemodialysis patients with low iPTH levels.
abstract: BACKGROUND
  Vitamin D [25(OH)D] deficiency is a cardiovascular risk factor in the hemodialysis (HD) population. The aim of this study was to identify hypovitaminosis D in HD patients without signs of hyperparathyroidism and to analyze its association to inflammation and echocardiographic alterations.
  
  
  METHODS
  Patients on HD with iPTH <300 pg/ml not receiving vitamin D therapy were recruited. Hypovitaminosis D was defined as 25(OH)D <30 ng/ml. High-sensitivity C-reactive protein, interleukin-6 and serum albumin were used as inflammation markers. Echocardiograms were performed in an interdialytic mid-week day.
  
  
  RESULTS
  Sixty-one patients (mean age of 56 ± 15 years, 52% males, 93% Caucasians, 31% diabetic) were included, and 75% presented hypovitaminosis D. Inflammation was more prevalent among those with hypovitaminosis D, and these patients presented higher relative wall thickness (0.48 ± 0.11 vs. 0.42 ± 0.10 mm; p = 0.05) and lower left ventricular diastolic (49.8 ± 6.2 vs. 54.7 ± 5.8 mm; p = 0.013) and systolic (31.9 ± 5.7 vs. 36.8 ± 7.2 mm; p = 0.012) diameters.
  
  
  CONCLUSIONS
  Hypovitaminosis D is associated with inflammation and concentric geometric pattern of the left ventricle, even in the absence of high iPTH levels. Vitamin D repletion (aiming to reduce cardiovascular complications) should also be considered in HD patients with normal or low iPTH levels.
authors.affiliation: Center for Health and Biological Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, PR, Brazil.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Bucharles
authors.forename: Silvio H
authors.initials: SH
authors.lastname: Barberato
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Stinghen
authors.forename: Betina
authors.initials: B
authors.lastname: Gruber
authors.forename: Henrique
authors.initials: H
authors.lastname: Meister
authors.forename: Andrieli
authors.initials: A
authors.lastname: Mehl
authors.forename: Luciana
authors.initials: L
authors.lastname: Piekala
authors.forename: Ana C
authors.initials: AC
authors.lastname: Dambiski
authors.forename: Admar
authors.initials: A
authors.lastname: Souza
authors.forename: Márcia
authors.initials: M
authors.lastname: Olandoski
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits-Filho
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D010281:Parathyroid Hormone / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors; D020257:Ventricular Remodeling / Q000502:physiology*; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D014807:Vitamin D