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Dialisi Peritoneale

25-HYDROXY VITAMIN D LEVELS ARE ASSOCIATED TO RESIDUAL RENAL FUNCTION PARAMETERS IN ADULT PERITONEAL DIALYSIS PATIENTS

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Introduction and Aims

25-hydroxy vitamin D (25(OH)D) levels may show some seasonal variance in dialysis patients due to differences in alimentation and sun exposure, but the relation between 25(OH)D levels and residual renal function in adult peritoneal dialysis (PD) patients is not known.

Methods

Weekly creatinine clearance (Crea-Cl), urea clearance (Urea-Cl), fractional excretion of urea (FE-Urea) and renal KT/V were analysed in 32 PD patients together with serum 25(OH)D.

All patients had residual diuresis of at least 100 ml per day and were under high dose furosemide therapy of at least 250 mg per day.

The patients did not receive oral vitamin D supplementation. Vitamin D receptor agonists (calcitriol or paricalcitol) were given to control calcium-phosphorous-parathormone.

Results

Adult PD patients (mean age 63±16 years) presented mean diuresis of 1108±683 ml per day, Crea-Cl of 49±34 L/week, Urea-Cl of 25±15 L/week, FE-Urea of 0.54±0.16 and renal Kt/V 0.68±0.46.

Mean values of 25(OH)D were at 13.9±7.7 ng/l. Two patients presented 25(OH)D levels above 30 ng/ml, five patients 25(OH)D insufficiency (20-30 ng/ml) and the remaining 25 patients deficiency (<20 ng/ml).

Serum 25(OH)D levels correlated to renal creatinine excretion (r=0.35, p=0.049), renal urea excretion (r=0.42, p=0.02), FE-Urea (r=0.40, p=0.02) and Urea-Cl (r=0.41, p=0.02), but not to diuresis, Cl-Crea or Kt/V.

Conclusions

Serum 25(OH)D was in the majority of cases in the range of deficiency.

Several parameters of residual renal function were associated to 25(OH)D, especially parameters regarding
urea elimination (daily urinary excretion of urea, FE-Urea and Urea-CL).

References

Hee Yeon Cho, Hye Sun Hyun, Hee Gyung Kang, Il Soo Ha, Hae Il Cheong. Prevalence of 25(OH) Vitamin D Insufficiency and Deficiency in Pediatric Patients on Chronic Dialysis. Perit Dial Int 2013; 33: 398-404.

N Shah, J Bernardini, B Piraino. Prevalence and correction of 25(OH) vitamin D deficiency in peritoneal dialysis patients. Perit Dial Int 2005; 25: 362-366.

KDIGO Clinical Practice Guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder. Kidney International 2009; 76 (Suppl 113): S22–S49.

release  1
pubblicata il  15 settembre 2013 
da Matthias Zeiler, Tania Monteburini, Rosa Maria Agostinelli, Rita Marinelli, Stefano Santarelli
(U.O. Nefrologia e Dialisi, Ospedale "Carlo Urbani", Jesi (AN))
Parole chiave: dialisi peritoneale, funzione renale, funzione renale residua, vitamina d
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Realizzazione: Tesi S.p.A.

Per assistenza contattare: Lucia Piumetto, Tesi S.p.A.
0172 476301 — lucia.piumetto@gruppotesi.com