Abstract: SA-PO268
Vitamin D Status in CKD Patients Living in the Tropics: A Cohort in Thailand
Session Information
- Bone and Mineral Metabolism: Calcium, Magnesium, Kidney Stones
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Kiattisunthorn, Kraiwiporn, Siriraj Medical School, Mahidol University, Bangkok-noi, Thailand
- Rodchuae, Muchima, Faculty of Medicine Siriraj Hospital, Bangplad, Thailand
Background
Vitamin D deficiency is a key factor of secondary hyperparathyroidism in CKD and is recommended to be evaluated in the cases found persistently elevated PTH levels. Data survey during the last decade showed vitamin D deficiency among the general Thais for 6-30% compared to 60-70% in the Eastern Asians. Data of prevalent vitamin D deficiency in Thailand is scarce, but is seriously concerned in clinical practice to balance between standard of care and healthcare budget restraint. Therefore, the study is done to evaluate vitamin D status and predictors of vitamin D deficiency in CKD patients living in Thailand
Methods
752 Stable CKD patients were included from CKD clinic and the outpatient section at Siriraj hospital. CKD is diagnosed based on KDIGO 2012 definition and GFR calculated with serum creatinine measured by using the enzymatic creatinine assay. Vitamin D levels were measured by using Elecsys® Vitamin D total (Roche Diagnostics, Germany). Albumin corrected serum calcium, phosphate, intact PTH, albuminuria were measured within 60 days of vitamin D levels, comorbidities and drugs related to vitamin D metabolism were collected.
Results
Mean age was 64.4+13.8 years old, 48% were female and 60.3% had diabetes mellitus. They were categorized to stage 1-2, 3a, 3b, 4 and 5 for 22.4, 18.7, 23.8, 24.1, and 11.0%, respectively. Prevalence of vitamin D deficiency (<20 ng/mL) and severe vitamin D deficiency (<10 ng/mL) were shown in Figure 1. Predicting factors of vitamin D deficiency in Thai CKD patients were stage 4-5 CKD 9.06 (3.64-22.58), albuminuria >1,500 mg/d 10.62 (3.97-28.41), calcium <9.0 mg/dL 3.99 (1.54-9.45), PTH >100 pg/mL 3.82 (1.54-9.49), diabetes 3.35 (1.33-8.46), and female 2.81 (1.19-6.62)
Conclusion
Vitamin D deficiency is highly prevalent in Thai stage 4-5 CKD patients. Considerations on GFR combined with serum calcium and PTH profiles and clinical characteristics would empower cost-effectiveness of 25-hydroxyvitamin D measurement in CKD population living in the tropic area.
Figure 1 Prevalence of vitamin D deficiency in Thai stage 1-5 CKD patients