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Nigerian Journal of Clinical Practice

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Predictors of Vitamin D deficiency in predialysis patients with stage 3–5 chronic kidney diseases in southern China

M. Feng, J. Lv, F.T. Huang, P.F. Liang, S. Fu, Y.C. Zeng, Y. Tang, A.P. Xu

Abstract


Objective: Vitamin D status and risk factors of Vitamin D deficiency in chronic kidney disease (CKD) patients in China have been seldom reported before. In this study, we aim to investigate serum 25‑hydroxyvitamin D [25(OH)D] status and find the predictors of Vitamin D deficiency in predialysis patients with Stage 3–5 CKDs in Southern China.

Methods: In this retrospective cross‑sectional study, hospitalized predialysis patients who were diagnosed of Stage 3–5 CKD and had taken measurement of serum 25(OH)D in a single center from January 2014 to June 2015 were included. Patients were divided into Vitamin D deficiency group and nondeficiency group  depending on the cutoff serum 25(OH)D value of 37 nmol/L. Clinical and  biochemical parameters were collected and evaluated for predictors of Vitamin D deficiency by logistic regression.

Results: One hundred and fifty‑two patients were included in this study, of which 87 (57.2%) were in Vitamin D insufficiency state while 60 (39.5%) were in Vitamin D deficiency state. Serum 25(OH)D levels of patients in Stage 4 and Stage 5 CKD were lower than that of patients in Stage 3 CKD (P = 0.002). It was discovered that female gender (odds ratio [OR] = 3.674; 95% confidence interval [CI],  1.607–8.396; P = 0.002), serum albumin level <30.0 g/L (OR = 6.816; 95% CI, 2.634–17.633; P < 0.001), and estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m2 (OR = 4.761; 95% CI, 1.353–16.754; P = 0.015) were  independent predictors of Vitamin D deficiency.

Conclusions: Vitamin D insufficiency and deficiency are common in predialysis patients with Stage 3–5 CKD in Southern China. Female gender, hypoalbuminemia with serum albumin level <30.0 g/L, and severe damaged renal function with eGFR <30 ml/min/1.73 m2 are independent predictors of Vitamin D deficiency in predialysis patients with Stage 3–5 CKD.

Keywords: Chronic kidney disease, predialysis, predictors, Vitamin D deficiency




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