Effects of Inactive Vitamin D on Persistent Secondary Hyperparathyroidism in Patients on Hemodialysis

Jalalzadeh, Mojgan; Mousavinasab, Seyed Nouraddin

doi:10.5812/numonthly.45029

Cited by 3 publications

(2 citation statements)

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“…A hospital based cross-sectional descriptive study was carried out to find out the prevalence of secondary Hyperparathyroidism in chronic renal failure patients. It is one of the leading causes of chronic morbidity and 11,13,14 In this study prevalence of secondary hyperparathyroidism in diabetic patients is 66% and in non-diabetic patients is 73%, that is supported by other study by Arevalo-lorido JC et al, in their study on 407 patients (214 diabetics) hyperparathyroidism was found in 60.4% of diabetic patient's vs 65% of non-diabetic patients. 15 This observation is also supported by Owda A et al, in their study there was no significant difference in serum PTH levels between diabetic and non-diabetic patients.…”

Section: Discussionsupporting

confidence: 81%

Study of prevalence of secondary hyperparathyroidism in chronic renal failure in hadoti region

et al. 2019

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Background: Secondary hyperparathyroidism is known and early complication of chronic renal failure patients. Aim of this study was to assess the prevalence of secondary hyperparathyroidism and correlation between serum parathyroid hormone level with biochemical parameters in renal failure patients in tertiary care hospital in Kota, Rajasthan.Methods: A cross sectional observational study was carried out in 50 patients who had creatinine clearance of 30ml/min/1.73m2 or less for greater than 6 weeks attended the OPD of department of General Medicine, New Medical College hospital, Kota, Rajasthan from May 2018 to November 2018. Investigations like complete blood count, renal function test, urine routine microscopy and USG abdomen with serum parathyroid hormone, serum phosphorus, serum calcium levels were done. Serum parathyroid hormone level was done by calorimetric method.Results: The prevalence of secondary hyperparathyroidism in our study was 72%.In hyperparathyroidism patient’s serum calcium level was low and the difference was highly significant (p<0.001). There is negative correlation between S.PTH and S. calcium level (r=-0.536). Mean serum calcium level in our study is 1.6mmol/l. In hyperparathyroidism patient’s serum phosphate level was high and the difference was highly significant (p<0.001). There was positive correlation between S.PTH and S.PO4 level (r=0.402). Mean serum phosphorus level in our study is 5.7 mg/dl. Prevalence of hyperparathyroidism was high among CRF patients with normal BP than hypertensive patients and with normal sugar than diabetics but the difference in proportion was not significant (p=0.87, p=0.98 respectively). 90% patients were on haemodialysis while 10% patients were on conservative management.Conclusions: Early detection of secondary hyperparathyroidism in chronic renal failure patients can reduce its complications like bone fracture and cardiovascular complications.

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Section: Discussionsupporting

confidence: 81%

Study of prevalence of secondary hyperparathyroidism in chronic renal failure in hadoti region

et al. 2019

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“…In HD patients, the lowest level of vitamin D3 was probably attributed to their low activity and not exposure to the sun; since the number of patients on stage 2 was low, we could not rely on this accidental finding. Based on a previous study (19) and our findings, there is an association between serum level of 25(OH) D3 and PTH levels at all stages of CKD; this connection was more obvious in stage 5 CKD patients. It is suggested that, if hyperparathyroidism is detected in CKD patients with vitamin D deficiency, this abnormality should be corrected with hyperparathyroidism control (8).…”

Section: Discussionmentioning

confidence: 99%

Relationship of circulating levels of 25(OH)D with parathyroid hormone in various stages of chronic kidney disease

Jalalzadeh¹,

Mousavinasab²,

Rostami³

2017

J Renal Inj Prev

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In a study on 115 patients with stages 2 to 5 CKD and the age of more than 14 years old, we found vitamin D deficiency as the serum level of 25 (OH)D3 <30 ng/mL, is common in CKD patients. There was a positive correlation between the serum levels of 25(OH)D3 and levels of PTH. The findings indicated that administration of vitamin D3 in all CKD patients with vitamin D deficiency was effective in reducing the serum levels of PTH. Please cite this paper as: Introduction:Vitamin D deficiency is common in both general population and chronic kidney disease (CKD) patients. Objectives: The aim of this study was to compare 25(OH)D3 levels in stages 2 to 5 of CKD patients and to evaluate whether inactive vitamin D supplement could prevent increasing of serum PTH levels. Patients and Methods: A total of 58 stages 2-4 CKD and 57 stage 5 CKD hemodialysis (HD) patients who had 25(OH)D3 <30 ng/mL were considered. All cases were under appropriate treatment for preventing secondary hyperparathyroidism. At the beginning, serum levels of vitamin D3, intact parathyroid hormone (iPTH), calcium (Ca), phosphate (P), alkaline phosphate (ALP) and albumin were measured. Patients received 300 000 IU/IM vitamin D3 and after 2 months this dosage was repeated, if it was necessary. All biochemical markers were checked and the effect of vitamin D3 was evaluated. Results: At base line, serum levels of 25(OH)D3 and PTH in patients with stages 2 to 5 of CKD were; 14.85±7.8 ng/mL (stage 2), 70.8 ± 16.8 pg/mL (stage 2); 16.48 ± 7.8 ng/mL (stage 3), 69.6 ± 39.2 pg/mL (stage 3); 16.33 ± 8.1 ng/mL (stage 4), 123.74 ± 92.5 pg/mL (stage 4); and 13.86 ± 6.5 ng/mL (stage 5) and 567.23 ± 276.7 pg/mL (stage 5), respectively. Two months after injections, 25(OH)D3 and PTH were changed as follow; 28.62 ng/mL (P = 0.001) (stage 2), 59.38 pg/mL (P = 0.34) (stage 2); 37.79 ng/mL (P < 0.001) (stage 3), 62.41 pg/ml (P = 0.18) (stage 3); 31.14 ng/mL (P = 0.001) (stage 4), 91.02 ± 69.4 pg/mL (P = 0.003) (stage 4) and 48.48 ng/mL (P < 0.001) (stage 5) and also 282.77 pg/mL (P < 0.001) (stage 5), respectively. Conclusion: The result of this study showed the vitamin D3 levels increased in all stages after 2 months. Also, the findings indicated that administration of vitamin D3 in all patients of the study groups reduced serum PTH levels. However, the rate of reduction was higher in stages 4 and 5 of CKD as compared to stages 2 and 3 of CKD (P < 0.001).This result encourages us to prescribe supplement vitamin D3 if the level is less than 30 ng/mL.

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Association of vitamin D status with liver and kidney disease: A systematic review of clinical trials, and cross-sectional and cohort studies

Parizadeh

Rezayi

Ghazizadeh

et al. 2021

International Journal for Vitamin and Nutrition Research

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Abstract. Background: Vitamin D deficiency (VDD) is a major public health problem. There are few comprehensive systematic reviews about the relationship between Vitamin D status and liver and renal disease in Iran. Methods: We systemically searched the following databases: Web of Science; PubMed; Cochrane Library; Scopus; Science Direct; Google Scholar and two Iranian databases (Scientific Information Database (SID) and IranMedex) up until November 2017 to identify all randomized control trials (RCTs), case control, cross-sectional and cohort studies investigating the association between vitamin D and any form of liver or kidney disease. Results: Vitamin D insufficiency, or deficiency (VDD), is highly prevalent in Iran, reports varying between 44.4% in Isfahan to 98% in Gorgan. There is also a high prevalence of VDD among patients with liver or kidney disease, and the administration of vitamin D supplements may have beneficial effects on lipid profile, blood glucose, liver function and fatty liver disease, and bone health. Low serum vitamin D levels are related with abnormalities in these laboratory and clinical parameters. Conclusion: VDD is prevalent in patients with chronic liver or renal disease in Iran. There appear to be several beneficial effects of vitamin D supplementation in vitamin D deficient patients with liver or kidney disease.

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Effects of Inactive Vitamin D on Persistent Secondary Hyperparathyroidism in Patients on Hemodialysis

Cited by 3 publications

References 30 publications

Study of prevalence of secondary hyperparathyroidism in chronic renal failure in hadoti region

Study of prevalence of secondary hyperparathyroidism in chronic renal failure in hadoti region

Relationship of circulating levels of 25(OH)D with parathyroid hormone in various stages of chronic kidney disease

Association of vitamin D status with liver and kidney disease: A systematic review of clinical trials, and cross-sectional and cohort studies

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