Correlation of Serum Vitamin D Levels to Vascular Access Dysfunction in Prevalent Hemodialysis

Abstract

Vascular access dysfunction in hemodialysis patients has been correlated to low serum vitamin D level in previous studies. Vitamin D deficiency and hepatitis C virus infection have been linked to endothelial cell dysfunction, promoting inflammatory cascade.30 negative - & 30 positive - hepatitis C virus patients on prevalent hemodialysis in Ain Shams University Hospitals, were enrolled in the study. All patients had access blood flow < 800 ml/min. For all patients we performed: complete physical examination, complete blood count, serum ferritin, ESR 1st and 2nd hours, CRP, blood urea, serum creatinine, serum albumin, total and direct bilirubin, alanine transferase, aspartate transferase, prothrombin time, International Normalized Ratio, serum calcium and phosphorus, and serum intact parathyroid hormone. Previous laboratory tests were performed using conventional methods within our hospitals laboratories. Serum vitamin Dlevel was measured by Enzyme Linked Immunosorbent Assay. Access blood flow was measured by Duplex Ultrasound. Vitamin D serum level was < 20 ng/ml within negative and positive groups with no significant difference between them. Vascular access flow was significantly lower within positive patients. Parathyroid hormone, Phosphorus, Prothrombin time, International Normalized Ratio, Alanine - and Aspartate - transferase were significantly higher within positive patients. We deduced that Vitamin D level < 20ng/ml was associated with reduced vascular access blood flow < 800 ml/min, with much more reduced access flow within hepatitis C virus positive patients. [Mona Hosny Abdel Salam, Reem Jan Farid, Mostafa Abdelnassier Abdelgawad and Marwa Salim Youssef Ismail. Correlation of Serum Vitamin D Levels to Vascular Access Dysfunction in Prevalent Hemodialysis.