RESUMO
Background: Vitamin D deficiency and insufficiency are common in patients with End Stage Renal Disease [ESRD]. Vitamin D has been found to have beneficial effects on bone, cardiovascular and immune functions. There are little data about vitamin D levels in Iraqi patients on hemodalysis
Objective: This study was conducted to determine the vitamin D status of Iraqi patients with ESRD on hemodialysis
Patients and Methods: This study is a cross sectional study conducted at The Dialysis Center/ Baghdad Teaching Hospital. An eighty four patients with End Stage Renal Disease [ESRD] on regular Hemodialysis [HD] enrolled in the study from January to February 2013. The basic data of the patients had been obtained [age, weight, duration on HD [months], infection with HCV, drugs doses for calcium and alphacalcidol Blood samples were collected at the start of the HD session from the vascular access for calcium, phosphorus, albumin, cholesterol, uric acid and Vitamin 25[OH] D3 blood levels. These samples were sent for analysis to the Teaching Laboratories at Medical City. Patients were considered as vitamin D3 insufficient if the levels were between 10 and 30 ng/ml deficient if the levels were less than 10 ng/ml and sufficient if it was >30 ng/ml We assess the correlation between vitamin D3 level and other variables tested in the study
Results: The mean age of the patients was 49.8 +/- 13.2 years, of these, 40 [47.6%] were females and 44 [52.4%] were males. Fifty five [65%] patients were infected with hepatitis C virus and 29 [35%] were not. the median dose of calcium carbonate was 1086.1 +/- 400 mg per day, The median dose of alphacalcidol wasl.9 +/- 1.1 mcg/week. Mean weight was 68.8 +/- 17.5 kg. Median duration of HD was 24.8 + 20.8 months [range 2-72 months]. The patients were on twice a week [6-8 hours/week] HD sessions. Mean of serum albumin, corrected calcium, phosphorus, Uric acid cholesterol were 3.0 +/- 0.8 g/dl., 8.6 +/- 1.4 mg/dl, 3.9 +/- 1.4 mg/dl, 6.1 + 2.4 mg/dl, 149.9 + 39.2 mg/dl respectively. Mean vitamin 25 [OH] D3 level was 33.02 + 7.2 ng/ml. 60 [71.4%] patients were vitamin D3 sufficient, 23 [27.4%] patients were vitamin D3 insufficient and only one [1.2%] patient was vitamin D3 deficient. There was a significant correlation between vitamin 25 [OH] D3 levels and albumin, duration of HD, virology status while there was no correlation between weight, sex ,age, activity, calcium, cholesterol, uric acid, phosphorus ,dose of alphacalcidol or calcium carbonate and vitamin 25 [OH] D3 level
Conclusion: The vitamin D insufficiency found in about one quarter of patients on hemodialysis while deficiency found only in 1.2% of patients and more than two third of patients had sufficient vitamin D3. There was a significant correlation between vitamin 25 [OH] D3 levels and albumin, duration of HD, virology status