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Vitamin D and parathyroid hormone status in community-dwelling elderly patients with mild-to-moderate kidney impairment

  • Nephrology - Original Paper
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Abstract

Introduction

Evidence on vitamin D and parathyroid hormone (PTH) status in patients with early kidney impairment is limited. We aimed to determine the associations among kidney function, vitamin D, and PTH status in community-dwelling elderly patients with mild-to-moderate kidney impairment.

Methods

Community-dwelling elderly patients were enrolled in this Institutional Review Board approved cross-sectional study. The eligibility criteria were as follows: age > 60 years, no recent hospitalization within the past 12 months, no conditions that affect vitamin D status including vitamin D supplementation, and eGFR > 30 mL/min/1.73 m2. Serum 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) levels were assessed.

Results

A total of 226 patients were enrolled. Data were expressed as mean ± SD. The mean serum 25(OH)D was 26.61 ± 10.44 ng/mL and the mean serum PTH was 50.67 ± 22.67 pg/mL. The prevalence of vitamin D deficiency [25(OH)D < 20 ng/mL] and secondary hyperparathyroidism [PTH > 65 pg/mL] were 25.3% and 18.1%, respectively. Patients with eGFR 30− < 60 mL/min/1.73m2 had significantly higher prevalence of 25(OH)D < 20 ng/mL (33.7% versus 19.4%, p < 0.05) than patients with eGFR ≥ 60 mL/min/1.73 m2. Multiple regression analysis showed independent negative association of serum PTH level with eGFR (mL/min/1.73 m2, β: − 0.261, 95% CI [− 0.408, − 0.114]) and serum 25(OH)D (ng/mL, β: − 0.499, 95% CI [− 0.775, − 0.223], adjusted for possible confounders).

Conclusions

The prevalence of vitamin D deficiency was higher in patients with eGFR 30 – < 60 mL/min/1.73 m2 than those with eGFR ≥ 60 mL/min/1.73 m2. Both decreased serum 25(OH)D levels and decreased eGFR were independently associated with increased serum PTH levels among these patients.

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Acknowledgement

The authors gratefully acknowledge the patients who generously agreed to participate in this study, Dr. Rachawit Sethpakdee for his assistance with patient interviews, and Mrs. Praneet Watanakejorn for her assistance as a study coordinator.

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  1. Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand

    Nipith Charoenngam & Sutin Sriussadaporn

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Charoenngam, N., Sriussadaporn, S. Vitamin D and parathyroid hormone status in community-dwelling elderly patients with mild-to-moderate kidney impairment. Int Urol Nephrol 53, 973–983 (2021). https://doi.org/10.1007/s11255-020-02695-5

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