Predictors of vitamin D status in predialysis chronic kidney disease patients: A cross-sectional analysis in a high ultraviolet climate

Petchey, William G., Johnson, David W., Hawley, Carmel M. and Isbel, Nicole M. (2011) Predictors of vitamin D status in predialysis chronic kidney disease patients: A cross-sectional analysis in a high ultraviolet climate. Journal of Renal Nutrition, 22 4: 400-408. doi:10.1053/j.jrn.2011.08.007


Author Petchey, William G.
Johnson, David W.
Hawley, Carmel M.
Isbel, Nicole M.
Title Predictors of vitamin D status in predialysis chronic kidney disease patients: A cross-sectional analysis in a high ultraviolet climate
Journal name Journal of Renal Nutrition   Check publisher's open access policy
ISSN 1051-2276
Publication date 2011-01-01
Year available 2011
Sub-type Article (original research)
DOI 10.1053/j.jrn.2011.08.007
Volume 22
Issue 4
Start page 400
End page 408
Total pages 9
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders
Collection year 2012
Language eng
Formatted abstract
Objective: To determine vitamin D status in a subtropical climate among an unselected, referred predialysis chronic kidney disease (CKD) population; assess risks and correlates; and review whether higher 25-hydroxyvitamin D (25-OHD) concentration can mitigate the decrement in circulating 1,25-dihydroxyvitamin D (1,25-OHD) normally encountered with advancing CKD.

Design: Prospective cross-sectional cohort study. Setting: Renal unit in Brisbane, Australia (27°28' S).

Subjects: Five hundred ninety-three consecutive CKD patients (stage 1 to 5). Main Outcome Measure: 25-OHD insufficiency (concentrations: 15 to 30 ng/mL) and deficiency (<15 ng/mL), bone-mineral parameters, including 1,25-OHD, calcium, and phosphate. Results: Despite potentially higher environmental ultraviolet (UV) exposure, only 48% of patients with CKD were 25-OHD sufficient. Traditional risks for hypovitaminosis D were maintained, and sufficiency was independently predicted by testing in the summer/autumn period (odds ratio [OR]: 2.77, 95% confidence interval [CI]: 1.88 to 4.08, P < .001), male gender (OR: 2.18, 95%CI: 1.46 to 3.24, P < .001), Caucasian race (OR: 2.28, 95%CI: 1.37 to 3.78, P = .001), hypoalbuminemia (OR: 0.47, 95%CI: 0.25 to 0.85, P = .01), macroalbuminuria (OR: 0.60, 95%CI: 0.39 to 0.92, P = .02), and normal body mass index (OR: 1.94, 95%CI: 1.22 to 3.07, P = .005). Vitamin D sufficiency was also associated with higher corrected calcium (0.4 mg/dL increments; OR: 1.29, 95%CI: 1.08 to 1.55, P = .005). Although circulating 25-OHD concentrations were relatively maintained across the range of renal function observed, 1,25-OHD concentrations decreased with advancing CKD.

Conclusion: 25-OHD insufficiency is mitigated but still highly prevalent in patients with CKD in a high ambient UV environment. Despite the maintenance of relatively higher 25-OHD concentrations with advancing CKD, substrate availability does not appear to be a major determinant of circulating 1,25-OHD.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article in Press. Available online 8 November 2011.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Thu, 15 Dec 2011, 23:10:21 EST by Matthew Lamb on behalf of School of Medicine