Mineral and bone disease - CKD 1-5

Le résumé fourni par la source

Introduction and Aims: Vitamin D deficiency is common in patients with chronic kidney disease (CKD) and can result in complications such as mineral and bone disorders. Vitamin D deficiency is also associated with extrarenal and extraskeletal complications. The purpose of this study is to determine the clinical and demographic risk factors for vitamin D deficiency in multiethnic CKD patients in Singapore, a sun-rich country, so that patients at risk for vitamin D deficiency can be identified early, and replacement with vitamin D supplements can be started before further worsening of their kidney function. Methods: Pre-dialysis CKD patients from the National University Hospital (NUH), Singapore, Outpatient Renal Clinic who had their serum 25-hydroxyvitamin D [25(OH)D] levels measured between January 2008 and October 2010 were included in the study. The patients' clinical and demographic parameters were collected from hospital databases and medical charts. Data mining methodology was used to identify potential predictors for vitamin D deficiency in these CKD patients. Two models, Mt30 and Mt16, were built using threshold serum 25(OH)D levels of £30 and <16 ng/mL, respectively. Results: A total of 219 patients were included in the study. Approximately 83% of the patients had serum 25(OH)D levels £30 ng/mL, while 25.6% had serum 25(OH)D levels <16 ng/mL. Four predictors of vitamin D deficiency were identified. Patients not taking vitamin D supplements (ergocalciferol/cholecalciferol), those with type 2 diabetes mellitus or younger in age were more likely to be vitamin D deficient. Malay and Indian race was also associated with vitamin D deficiency. The area under the receiver-operating curve for the validation sets were 0.708 and 0.752 for the Mt30 and Mt16 models, respectively. Conclusions: Vitamin D deficiency is common among multiethnic CKD patients in Singapore. Risk factors for vitamin D deficiency identified in this study include absence of vitamin D supplementation, presence of diabetes mellitus, younger age, and Malay and Indian race. The knowledge of these risk factors is useful for predicting vitamin D deficiency in CKD patients in Singapore. This can guide healthcare professionals on their decisions to prescribe vitamin D supplements to CKD patients at risk for vitamin D deficiency.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.