High prevalence of vitamin D deficiency in north Indian adults is exacerbated in those with chronic kidney disease

Jabbar, Zulfikar; Aggarwal, Pardeep K.; Chandel, Nirupama; Kohli, Harbir Singh; Gupta, Krishan Lal; Sakhuja, Vinay; Jha, Vivekanand

doi:10.1111/j.1440-1797.2008.01082.x

Cited by 32 publications

(25 citation statements)

References 27 publications

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“…A high prevalence of vitamin D insufficiency has been found in all ages in northern India [1,5]. The 25OHD levels were not readily available at our hospital and were carried out at one instance for patients as a part of the study.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with chronic kidney disease (CKD) are much more likely to have low levels of 25OHD due to decreased exposure to sunlight, low endogenous synthesis of vitamin D 3 in the skin and reduced intake of foods that are natural sources of vitamin D [4]. Whereas a recent study showed that 99% of adults with CKD 4-5 in north India had vitamin D insufficiency [5], similar estimates are unknown for children with CKD.…”

Section: Introductionmentioning

confidence: 97%

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Vitamin D insufficiency and effect of cholecalciferol in children with chronic kidney disease

et al. 2010

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Vitamin D insufficiency is common in patients with chronic kidney disease (CKD) and may contribute to mineral bone disease. In a prospective interventional study, we estimated the prevalence of vitamin D insufficiency (serum 25-hydroxyvitamin D3 [25OHD] < 30 ng/ml), and examined the effect of high-dose (600,000 IU) cholecalciferol supplementation after 6 weeks on serum 25OHD and parathyroid hormone (PTH) levels in children with CKD stages 2-4. Forty-two children (86% boys) with a mean age of 7.7 ± 3.8 (range 2--5) years were studied. Thirty-seven children (82.1%) had vitamin D insufficiency; 18 (42.8%) had 25OHD < 16 ng/ml. The median 25OHD increased significantly from 16.7 (95% CI 11.3, 19.8) to 46.2 (34.5, 44.6) ng/ml in patients with vitamin D insufficiency (P <0.001). The median PTH decreased significantly from 51.3 (95% CI 46.7, 71.5) to 37.1 (29.0, 54.6) pg/ml (P = 0.003). Nineteen patients (47.5%) had >30% reduction in the PTH after supplementation. Serum calcium, phosphorus, and estimated GFR did not change significantly. We conclude that vitamin D insufficiency is highly prevalent in children with CKD stages 2-4. High-dose cholecalciferol is safe and effective in correcting vitamin D insufficiency and results in a significant reduction in PTH levels in vitamin D-insufficient children.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Vitamin D insufficiency and effect of cholecalciferol in children with chronic kidney disease

et al. 2010

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“…Evidence has not favored the association between hypoalbuminemia and other endocrine abnormalities in CKD [18]. However, hypoalbuminemia in patients with CKD is an independent risk factor for cardiovascular mortality [19].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Subclinical Hypothyroidism in Patients with End-Stage Renal Disease and the Role of Serum Albumin: A Cross-Sectional Study from South India

et al. 2011

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Background/Aim: Subclinical hypothyroidism (SCH) and end-stage renal disease (ESRD) are independent risk factors for cardiovascular mortality. We aimed to study the prevalence of SCH in ESRD patients and assessed its associated risk factors. Methods: This cross-sectional study was conducted at 2 tertiary-care centers in Chennai, India, over a 3-year period. The study group comprised 137 patients with ESRD on thrice weekly regular maintenance hemodialysis. Free thyroxine (FT₄) and thyroid-stimulating hormone (TSH) were measured using an electrochemiluminescence immunoassay. SCH was defined as TSH ranging between 4.5 and 10 mIU/l with normal FT₄ (0.93–1.7 ng/dl). Patients with overt hypothyroidism, SCH and overt hyperthyroidism, those on medications affecting thyroid function and pregnant women were excluded from the study. Results: Of 137 ESRD patients (mean age: 43 ± 13.38 years), 107 were males (78.1%), 45 diabetics (32.8%), 127 hypertensives (92.7%), and 38 smokers (27.7%). Prevalence of SCH was 24.8%. In unadjusted (OR: 3.37, 95% CI: 1.91–5.21) and adjusted (for age, gender, HbA_1C, and albumin/creatinine ratio; OR: 3.11, 95% CI: 2.15–4.98) logistic regression analysis, serum albumin was significantly associated with SCH. Further, multiple linear regression identified that for every 1 g/dl drop in serum albumin TSH increased by 4.61 mIU/l (95% CI: 2.75–5.92). Conclusion: We observed a high prevalence of SCH in our ESRD patients. Also, serum albumin was significantly associated with SCH in our study.

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“…8 Evidence has not favored the association between hypoalbuminemia and other endocrine abnormalities in CKD. 9 However, hypoalbuminemia in patients with CKD is an independent risk factor for cardiovascular mortality. 10 There have been controversies as to whether SCH in ESRD warrants thyroxine supplementation.…”

Section: Discussionmentioning

confidence: 99%

Thyroid dysfunction in patients of chronic kidney disease

et al. 2017

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Background: Thyroid hormones play a very important role in regulating metabolism, development, protein synthesis, and influencing other hormone functions. CKD has been known to affect the pituitary-thyroid axis and the peripheral metabolism of thyroid hormones. We aimed to study the thyroid dysfunction in patients of chronic kidney disease for the prevalence of subclinical hypothyroidism.Methods: This cross-sectional study was conducted at Chhatrapati Shivaji Subharti Hospital and Medical College, Meerut, Uttar Pradesh, India, over a 2 year period. The study group comprised 100 patients with Chronic kidney disease. Free thyroxine (fT3, fT4) and thyroid-stimulating hormone (TSH) were measured. Patients with family history of thyroid disorder or past history of any medication for thyroid disease or history of any surgery or any radiological intervention to thyroid gland were excluded from the study.Results: Of 100 CKD patients, 25 were found to have subclinical hypothyroidism (SCH) and 75 were euthyroid. The mean age in patients with SCH was 47.72±10.09 and in euthyroid patients was 46.11±14.332. 12 males (48%) and 13 females (52%) patients were found to have subclinical hypothyroidism and 49 male (65%), 26 female (35%) patients were euthyroid. Prevalence of SCH was 25% with a mean TSH level of 8.68± 1.84.Conclusions: We observed a high prevalence of SCH in our CKD patients. SCH is an additional risk factor in CKD patients and the present study finds thyroid dysfunction being SCH to be very common in CKD patients and reveals significant association between CKD progression and thyroid dysfunction.

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High prevalence of vitamin D deficiency in north Indian adults is exacerbated in those with chronic kidney disease

Cited by 32 publications

References 27 publications

Vitamin D insufficiency and effect of cholecalciferol in children with chronic kidney disease

Vitamin D insufficiency and effect of cholecalciferol in children with chronic kidney disease

Prevalence of Subclinical Hypothyroidism in Patients with End-Stage Renal Disease and the Role of Serum Albumin: A Cross-Sectional Study from South India

Thyroid dysfunction in patients of chronic kidney disease

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