˝EVALUATE THE STATUS OF SERUM 25-HYDROXYVITAMIN D WITH URINARY ALBUMIN CREATININE RATIO AND TO SEE ITS ASSOCIATION WITH ECG CHANGES IN CHRONIC KIDNEY DISEASES

Anuradha Bharosay, Tariq Jalaly, Vivek Vikram Bharosay, Palak Talreja

Abstract


Aims: Evaluate the status of serum 25-Hydroxyvitamin D with Urinary Albumin Creatinine Ratio and to see its association with ECG changes in chronic kidney diseases.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Biochemistry, Department of Medicine, Department of Nephrology Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh between June 2019 to November 2019.

Methodology: 100 known or newly diagnosed CKD patients  above 18 yrs of age were included. Patients on dialysis, Vitamin D therapy, obstructive nephropathy, gout, or having   H/O IHD were excluded from the study. eGFR was calculated by CKD-EPI formula and patients were grouped into various stages of CKD based on KDOQI classification. Spot urinary albumin(immunoturbidimetric method) and urinary creatinine(buffered kinetic Jaffes reaction) were done on Cobas Integra 400 Plus and ACR was determined. Albuminuria (ACR) categories in CKD were listed as A1 : <30mg/g ; A2: 30-300mg/g and A3: >300mg/g  Quantitative determination of total 25‑hydroxyvitamin D in human serum was done on Cobas e411 based on electrochemiluminescence binding assay. 25-OH vitamin D deficiency , insufficiency and sufficiency  were defined as levels <30 nmol/L , 30-50 nmol/L and > 50 nmol/L.12 lead ECG was done at the time of admission and interpretation done by a qualified physician based on accepted standard criteria.

Result:  Out of 100 CKD patients 45 were in stage V, 36 in stage IV,14 in stage III and 5 were in stage II. 94% of patients were found to have vitamin D deficiency. 72% had vitamin D <30 nmol/L out of which 88.8% patients were in Stage IV and stage V CKD. Mean ACR was 344.9±163.5. A significant association was observed (p<0.05) between ACR and Vitamin D as well as severity of CKD and Vitamin D deficiency. ECG abnormalities were observed in 75% patients with 57% ECG abnormality present in CKD patients with vitamin D <30nmol/L. Significant association (p<0.05) was observed between Vitamin D status and ECG abnormalities.

Conclusion:  25-hydroxyVitamin D has been observed to have a renoprotective as well as cardioprotective role in CKD patients. This study can be of immense utility for alleviating  progression and cardiovascular risk in CKD patients


Keywords


Kidney Disease Outcome Quality Initiative (KDOQI); Chronic kidney disease(CKD) ; Electrocardiogram(ECG) ;Albumin Creatinine ratio(ACR)

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References


Min B. Effects of Vitamin D on blood pressure and endothelial function. Korean J Physiol Pharmacol. 2013;17(5):385–92.

Scragg R, Sowers MF, Bell C. Serum 25-hydroxyvitamin D, Ethnicity, and Blood Pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens. 2007

Bodyak N, Ayus JC, Achinger S, Shivalingappa V, Ke Q, Chen YS, et al.

Activated vitamin D attenuates left ventricular abnormalities induced by dietary sodium in Dahl salt-sensitive animals. Proc Natl Acad Sci U S A. 2007;104(43):16810–5.

Aihara K, Azuma H, Akaike M, Ikeda Y, Yamashita M, Sudo T, et al. Disruption of Nuclear Vitamin D Receptor Gene Causes Enhanced Thrombogenicity in Mice 2004;279(34):35798–802.

Stöhr R, Schuh A, Heine GH, Brandenburg V. FGF23 in Cardiovascular Disease : Innocent Bystander or Active Mediator 2018;9(June).


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