Taskapan H, Baysal O, Karahan D, Durmus B, Altay Z, Ulutas O
Nephrology Department, Turgut Ozal Medical Center of Inonu University, Medical Faculty, Malatya, Turkey.
Clin Nephrol. 2011 Aug;76(2):110-6. doi: 10.5414/cn107160.
25(OH)D deficiency has been associated with significantly worse physical performance in individuals with normal renal function. We examined the physical function, muscle strength and balance in age- and gender-matched 25 Stage 3 - 4 CKD patients and 47 Stage 5 CKD patients on peritoneal dialysis (PD) with vitamin D deficiency by objective methods and evaluated the effect of vitamin D replacement on physical performance tests: the "timed up and go" (TUG) test, gait velocity test, timed chair stand test, stair climb test, dynamic balance tests (TUG test, dynamic postural stability test), static balance test (functional reach test) and muscle strength in these two groups. At baseline 25(OH)D in the Stage 3 - 4 CKD patients and patients on PD were 6.9 ± 3.5 ng/ ml (17.2 ± 8.7 nmol/l) and 5.7 ± 3.3 ng/ml (14.2 ± 8.2 nmol/l), respectively (p > 0.05). Mean (± SD) 25(OH)D in Stage 3 - 4 CKD patients and those on PD were 52.0 ± 40.9 ng/ml (129.7 ± 102.2 nmol/l) and 41.9 ± 21, ng/ml (104,5 ± 52,6 nmol/l) respectively after vitamin D replacement (p > 0.05). When both Stage 3 - 4 CKD and dialysis patients became vitamin D-sufficient after vitamin D replacement, they took a significantly shorter time to complete the TUG test, gait velocity test, the timed chair stand test and stair climb test. Results of physical performance tests, static and dynamic balance tests and isometric strength tests improved in both groups after the treatment (p < 0.05). In conclusion, our results show that vitamin D supplementation improves muscle strength, functional ability and balance in both CKD and dialysis patients.
在肾功能正常的个体中，25(OH)D缺乏与显著更差的身体机能相关。我们通过客观方法检查了年龄和性别匹配的25例3 - 4期慢性肾脏病（CKD）患者以及47例接受腹膜透析（PD）的5期CKD维生素D缺乏患者的身体功能、肌肉力量和平衡能力，并评估了维生素D替代治疗对身体机能测试的影响：“起立行走”（TUG）测试、步态速度测试、定时起立试验、爬楼梯测试、动态平衡测试（TUG测试、动态姿势稳定性测试）、静态平衡测试（功能性伸展测试）以及这两组患者的肌肉力量测试。基线时，3 - 4期CKD患者和接受PD治疗的患者的25(OH)D水平分别为6.9±3.5 ng/ml（17.2±8.7 nmol/l）和5.7±3.3 ng/ml（14.2±8.2 nmol/l）（p>0.05）。维生素D替代治疗后，3 - 4期CKD患者和接受PD治疗患者的平均（±标准差）25(OH)D水平分别为52.0±40.9 ng/ml（129.7±102. nmol/l）和41.9±21 ng/ml（104.5±52.6 nmol/l）（p>0.05）。当3 - 4期CKD患者和透析患者在维生素D替代治疗后维生素D水平充足时，他们完成TUG测试、步态速度测试、定时起立试验和爬楼梯测试的时间显著缩短。治疗后两组患者的身体机能测试、静态和动态平衡测试以及等长力量测试结果均有所改善（p<0.05）。总之，我们结果表明，补充维生素D可改善CKD患者和透析患者的肌肉力量、功能能力和平衡能力。
