title: The effect of some medications given to CKD patients on vitamin D levels.
abstract: BACKGROUND
  Vitamin D deficiency and polypharmacy is a common problem over chronic kidney disease (CKD) population.
  
  
  OBJECTIVE
  To assess the clinical and analytical characteristics of CKD patients with 25-OH-D3 deficiency (<15 ng/mL), including the possible role of associated drugs.
  
  
  METHODS
  A single center observational review of 137 incident patients referred to our outpatient clinic with different stages of CKD and 25-OH-D3<15ng/mL (male gender 53.3%, mean age 70.8 [±16.1] years, mean GFR (MDRD-4) 43.6 [±25.5] ml/min/1.73 m²). 25-OH-D3 levels were collected in spring. Clinical and biochemical data and associated medications were recorded.
  
  
  RESULTS
  Mean 25-OH-D3 levels were 8.23 [±4.03] ng/ml. Eighty-eight patients (64.7%) had 3 or more concomitant drugs. Only 7 patients (5.1%) were not receiving any medication. Patients were divided in three groups according the therapies into none (n=26), RAS inhibitors or allopurinol (n=81), and RAS inhibitors plus allopurinol (n=30); with the aim to study the influence of statin therapy. Patients under renin angiotensin (RAS) inhibitors or Allopurinol treatment presented significantly higher 25-OH-D3 levels (p=0.001 and p=0.01 respectively), however patients with Statins treatment had lower 25-OH-D3 level (p=0.039). Personal history of diabetes, cardiovascular events or other therapies did not modify 25-OH-D3 levels, adjusted by age and eGFR.
  
  
  CONCLUSIONS
  CKD patients with vitamin D deficiency who received RAS inhibitors or Allopurinol treatment had higher 25-OH-D3 levels, however those with statins treatment had lower vitamin D levels. Randomized controlled trials are required to confirm these findings.
authors: Department of Nephrology. Gregorio Marañón University General Hospital. Madrid (Spain). Electronic address: claudiayustelozano@yahoo.es.
authors: Claudia
authors: C
authors: Yuste
authors: Department of Nephrology. Gregorio Marañón University General Hospital. Madrid (Spain).
authors: Borja
authors: B
authors: Quiroga
authors: Department of Nephrology. Gregorio Marañón University General Hospital. Madrid (Spain).
authors: Soledad García
authors: SG
authors: de Vinuesa
authors: Department of Nephrology. Gregorio Marañón University General Hospital. Madrid (Spain).
authors: Maria Angeles
authors: MA
authors: Goicoechea
authors: Department of Nephrology. Gregorio Marañón University General Hospital. Madrid (Spain).
authors: Daniel
authors: D
authors: Barraca
authors: Department of Nephrology. Gregorio Marañón University General Hospital. Madrid (Spain).
authors: Ursula
authors: U
authors: Verdalles
authors: Department of Nephrology. Gregorio Marañón University General Hospital. Madrid (Spain).
authors: Jose
authors: J
authors: Luño
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000009:adverse effects / Q000493:pharmacokinetics*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000493:pharmacokinetics*; D002112:Calcifediol / Q000097:blood* / Q000172:deficiency; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D005260:Female; D005919:Glomerular Filtration Rate; D006397:Hematinics / Q000009:adverse effects / Q000493:pharmacokinetics*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D012084:Renin-Angiotensin System / Q000187:drug effects; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000139:chemically induced* / Q000209:etiology
chemical_list: D000959:Antihypertensive Agents; D006397:Hematinics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D000493:Allopurinol; D002112:Calcifediol
keywords: Allopurinol; Alopurinol; Chronic kidney disease; Enfermedad renal crónica; Estatinas; Inhibidores RAS; RAS inhibitors; Statins; Vitamin D; Vitamina D