title: [Clinical and biochemical characteristics of predialysis patients in terms of 25 hydroxy vitamin D levels].
abstract: BACKGROUND
  Decreased levels of 25 hydroxyvitamin D (25[OH]D) have been reported in patients with chronic kidney disease (CKD). The pleiotropic effects of vitamin D are known to go beyond mineral metabolism.
  
  
  OBJECTIVE
  The aims of this study were to: 1) Determine the 25(OH)D levels in predialysis outpatients. 2) Find out the clinical and biochemical characteristics of patients with 25(OH)D deficiency, and predictive factors for the deficiency.
  
  
  METHODS
  An observational study in 79 predialysis outpatients was performed. Clinical and biochemical parameters were analysed in terms of nutrition, inflammation and mineral metabolism in relation to serum levels of 25(OH)D. Levels of 25(OH)D lower than 15ng/ml were considered to be deficient.
  
  
  RESULTS
  Serum levels of 25(OH)D were deficient in 41 patients (52%). The comparative study regarding levels of vitamin 25(OH)D showed the group of patients with a deficiency, i.e. those with less than 15ng/ml, were older (70 ± 11.97 vs. 61 ± 14.5; p = 0.005), had a greater body mass index, BMI, (30±4.06 vs. 27.1 ± 5.08; p = 0.003) and increased proteinuria (1.42g/24h (0.53-2.96) vs. 0.51 (0.20-1.48), p = 0.009). This group included a greater number of diabetic patients: 20 (76.9%) vs. 6 (23%), p = 0.002. They had a higher level of parathyroid hormone (PTH): 359 (239-658) vs. 233 (129-323), p = 0.000; and more patients were under treatment with Calcitriol: 28 (62.2%) vs. 17 (37.8%), p = 0.024. In the multivariate analysis, high levels of PTH (OR 13.38; CI 95% [2.94-60.89]; p=0.001), increased proteinuria (OR 4.41; CI 95% [1.12-17.25]; p = 0.033); and being diabetic (OR 5.713; CI 95% [1.43-22.77]; p = 0.014) were independent predictor factors for patients with 25(OH)D deficiency.
  
  
  CONCLUSIONS
  In our study, we observed a high prevalence of 25(OH)D deficiency among patients with CKD. The increased levels of PTH, the increase of proteinuria and the presence of diabetes were independent predictors for 25(OH)D deficiency.
authors: Sección de Nefrología, Hospital Severo Ochoa, Avda de Orellana, Leganés, Madrid. irodriguez.hsvo@salud.madrid.org
authors: I
authors: I
authors: Rodríguez Villarreal
authors: O
authors: O
authors: Ortega
authors: P
authors: P
authors: Gallar
authors: M
authors: M
authors: Sánchez
authors: R
authors: R
authors: Callejas
authors: C
authors: C
authors: Gracia
authors: C
authors: C
authors: García la Calle
authors: M
authors: M
authors: Ortiz
authors: J C
authors: JC
authors: Herrero
authors: C
authors: C
authors: Mon
authors: A
authors: A
authors: Oliet
authors: A
authors: A
authors: Vigil
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002117:Calcitriol / Q000627:therapeutic use; D015913:Chelation Therapy; D015897:Comorbidity; D003928:Diabetic Nephropathies / Q000097:blood / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology / Q000652:urine; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D010281:Parathyroid Hormone / Q000097:blood; D011507:Proteinuria / Q000097:blood / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002117:Calcitriol