title: Effects of sun exposure and dietary vitamin D intake on serum 25-hydroxyvitamin D status in hemodialysis patients.
abstract: OBJECTIVE
  Vitamin D deficiency is common in hemodialysis patients. The aim of this study was to identify whether or not sun exposure and dietary vitamin D intake have effects on serum 25-hydroxyvitamin D (25(OH)D) status in hemodialysis (HD) patients. The objective was to identify the main determinants of serum vitamin D status in the study subjects.
  
  
  METHODS
  A cross-sectional study of 47 HD patients (19 males and 28 females) was performed. We assessed serum 25(OH)D and 1,25(OH)2D levels between August and September 2012 and analyzed the prevalence of vitamin D deficiency in HD patients. To evaluate the determinants of serum 25(OH)D levels, we surveyed dietary vitamin D intake, degree of sun exposure, and outdoor activities. To compare biological variables, serum 25(OH)D was stratified as below 15 ng/ml or above 15 ng/ml.
  
  
  RESULTS
  Mean 25(OH)D and 1,25(OH)2D levels were 13.5 ± 5.8 ng/ml and 20.6 ± 11.8 pg/ml, respectively. The proportions of serum 25(OH)D deficiency (< 15 ng/ml), insufficiency (15-< 30 ng/ml), and sufficiency (≥ 30 ng/ml) in subjects were 72.4%, 23.4%, and 4.3%, respectively. Prevalence of vitamin D deficiency in female patients was 78.6%, whereas that in males was 63.2% (P = 0.046). Vitamin D intake and sun exposure time were not significantly different between the two stratified serum 25(OH)D levels. Dietary intake of vitamin D did not contribute to increased serum 25(OH)D levels in HD patients. The main effective factors affecting serum 25(OH)D status were found to be the sun exposure and active outdoor exercise.
  
  
  CONCLUSIONS
  Hypovitaminosis D is common in HD patients and is higher in females than in males. Sun exposure is the most important determinant of serum 25(OH)D status in HD patients.
authors: Department of Food and Nutrition, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea.
authors: Yeon Joo
authors: YJ
authors: Lee
authors: Department of Nephrology, Hanyang University Seoul Hospital, Seoul 133-792, Korea.
authors: Il Hwan
authors: IH
authors: Oh
authors: Department of Nutrition, Hanyang University Seoul Hospital, Seoul 133-792, Korea.
authors: Hee Jun
authors: HJ
authors: Baek
authors: Department of Nephrology, Hanyang University Seoul Hospital, Seoul 133-792, Korea.
authors: Chang Hwa
authors: CH
authors: Lee
authors: Department of Food and Nutrition, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea.
authors: Sang Sun
authors: SS
authors: Lee
keywords: 25-hydroxyvitamin D; Hemodialysis; hypovitaminosis D; sun-exposure