Vitamin D Deficiency in End Stage Renal Disease Patients with Diabetes Mellitus Undergoing Hemodialysis

Abstract

Objectives: To assess the association of hypovitaminosis D with diabetes mellitus (DM) in patients with end stage renal disease (ESRD) undergoing hemodialysis. Methodology: This cross-sectional study was conducted at the Jinnah Postgraduate Medical Centre between July 2019 and February 2020. Patients with diagnosed ESRD who were on hemodialysis, with or without concomitant DM were registered. Vitamin D levels were categorized according to the severity of the deficiency or excess as 0-10 ng/mL, severely deficient; 11-20 ng/mL, deficient; 21-32 ng/mL; insufficient, 33-49 ng/mL, adequate; 50-65 ng/mL, optimum; and above that as high. Patients were stratified according to the status of DM. Results: In a total of 80, the mean age was 45.21±12.67 years with 51 (63.75%) males and 29 (36.25%) females. A total of 36 (45%) CKD patients had concomitant diabetes. The median vitamin D levels were 20.25ng/mL. It was found that chronic kidney disease (CKD) patients with concomitant DM had significantly lower levels of vitamin D [15.19±6.83 vs. 30.28±14.22 (p<0.001)]. Out of the 12 patients with a severe deficiency, three-fourths of the population had DM as comorbidity, while in those with 'deficiency', 19 (67.9%) had DM. The majority of the patients without DM had adequate or optimum levels of serum 25hydroxyvitamin D levels. Conclusion: Current study indicated that deficiency of serum vitamin D is associated with concomitant DM in patients with CKD as the majority had a severe deficiency of serum 25(OH)D. Supplemental vitamin D may help correct the deficiency and prevent the associated complications in patients.

Factors Associated with Hypovitaminosis D in People Living with HIV/AIDS (PLWHA) Followed up in Porto-Novo in 2019

“…The association between decreased glomerular filtration rate i.e. renal failure and vitamin D deficiency was reported by Ali [28] and Singh [29]. This would be due at least in part, to the renal synthesis defect of 1α hydroxylase necessary for vitamin D metabolism.…”

Vitamin D Deficiency as a Predictor of a High Prevalence of Coronary Artery Disease in Pancreas Transplant Candidates With Type 1 Diabetes

“…In addition, other researchers reported that VDD can be associated with diabetic nephropathy in both type 1 and type 2 diabetes ( 39 , 40 ). Moreover, diabetic patients on hemodialysis have significantly lower levels of vitamin D than patients without diabetes ( 41 ). On the other hand, Diaz et al.…”

“…with diabetic nephropathy in both type 1 and type 2 diabetes (39,40). Moreover, diabetic patients on hemodialysis have significantly lower levels of vitamin D than patients without diabetes (41). On the other hand, Diaz et al reported that diabetic patients with nephropathy present significantly higher prevalence of VDD than patients without nephropathy (42).…”

Secondary hyperparathyroidism in diabetic kidney disease patients treated with hemodialysis

“…Недостатність вітаміну Д 25 (ОН) оцінена на рівні <50 нмоль/л була виявлена у 91% (n=51)серед пацієнтів з ЦД, з них важкий дефіцит вітаміну Д <25 нмоль/л був у 51,7% (n=29) пацієн-тів, а серед пацієнтів без діабету недостатність вітаміну Д 25 (ОН) визначалась у 92% (n=192) пацієнтів, з них важкий дефіцит вітаміну Д у 33,3% (n=69) пацієнтів. Отримані дані співставні з джерелами літератури [9,10].…”

“…Вітамін Д має плейотропну дію на імунну, серцево-судинну та неврологічну системи, а також протипухлинну активність. Позаниркові органи мають ферментативну здатність перетворювати 25(OH)Д в 1,25(OH)Д. Пацієнти із ХХН >80% мають низькі рівні 25(OH)Д у сироватці крові [9,10]. Спостережні дослідження повідомляли про прогресуюче погіршення дефіциту вітаміну Д від III до 5V Д стадії [20].…”