Abstract
Background
Vitamin D status of Thai patients receiving renal replacement therapy (RRT) is incompletely known.
Objectives
To determine the prevalence of vitamin D deficiency or insufficiency in adult Thai patients receiving various RRT modalities, and factors associated with low vitamin D levels.
Methods
In this retrospective, observational, single-center, cross-sectional study, we evaluated dialysis-related laboratory test variables from 111 patients receiving RRT. Serum 25-hydroxyvitaminD concentration [25(OH)D] < 15 ng/mL was defined as deficiency, and 15–30 ng/mL as insufficiency.
Results
Low vitamin D levels were identified in 100% patients receiving peritoneal dialysis (PD; 81% deficient, 19% insufficient), 94% patients receiving online-hemodiafiltration (OL-HDF; 50% deficient, 44% insufficient), and 100% patients with kidney transplants (KT; 55% deficient, 45% insufficient). PD patients showed significantly lower serum [25(OH)D] than OL-HDF or KT patients (10.5 ± 5.9 vs 17.7 ± 8.5 vs 15.4 ± 6.1 ng/mL respectively, P < 0.001). OL-HDF patients with vitamin D deficiency had significantly lower vascular access flow than those without deficiency (833 ± 365 vs 1239 ± 385 mL/min, P = 0.008). KT recipients from deceased donors had lower serum [25(OH)D] than KT recipients from living, related donors (13.7 ± 6.0 vs 17.5 ± 5.7 ng/mL, P = 0.045). Multiple logistic regression found treatment by renin-angiotensin system blockade, serum triglyceride, and intact parathyroid hormone levels significantly associated with vitamin D deficiency after adjusting for sex, and serum calcium, phosphate, and albumin levels.
Conclusions
Nearly 100% patients receiving RRT had vitamin D deficiency or insufficiency, and RRT modalities might be related.