El Din Usama Sharaf, Fayed Ahmed, El Nokeety Mahmoud M, Abdulazim Dina O, Salem Mona M
Department of Internal Medicine, Nephrology Unit, School of Medicine, Cairo University, Cairo, Egypt.
Department of Rheumatology and Rehabilitation, School of Medicine, Cairo University, Cairo, Egypt.
Saudi J Kidney Dis Transpl. 2019 Nov-Dec;30(6):1389-1397. doi: 10.4103/1319-2442.275483.
Currently, there is no available data about Vitamin D status among Egyptian chronic kidney disease (CKD) patients. This cross-sectional study is looking for the prevalence of Vitamin D deficiency among Stage 3a-5 CKD Egyptian patients and its possible associations. We studied 1624 Stage 3a-5 CKD adults (689 males and 935 females) together with 200 normal control persons. All the recruited candidates were tested for body mass index (BMI); serum levels of blood urea nitrogen, creatinine, calcium (Ca), phosphorus (P), parathyroid hormone (PTH), 25 hydroxy vitamin D (25(OH)D), albumin, and uric acid (UA); urine albumin/creatinine ratio (ACR), and estimated glomerular filtration rate. The optimal level of Vitamin D was encountered in only 1.4% of CKD patients versus 52% of the normal controls. A total of 1107 (68.2%) CKD patients versus 23 (11.5%) controls had serum 25(OH)D <20 ng/mL (mean ± standard deviation = 16.8 ± 5.8 versus 37.3±7.6 ng/mL for CKD versus control group, respectively, P <0.001). There was a highly statistically significant positive correlation between serum 25(OH)D and serum Ca (r = 0.299, P <0.001) and a highly statistically significant negative correlation between serum 25(OH)D on the one hand and serum P, serum PTH, serum UA, and urine ACR on the other hand (r = -0.46, -0.69, -0.73, and -0.8, respectively, P <0.001). Vitamin D deficiency is very common among Egyptian CKD patients. Serum P, UA, and urine ACR ratio are the most important variables which are found to be negatively associated with serum 25(OH)D.
目前，尚无关于埃及慢性肾脏病（CKD）患者维生素D状况的可用数据。这项横断面研究旨在探寻3a - 5期CKD埃及患者中维生素D缺乏症的患病率及其可能的关联因素。我们研究了1624例3a - 5期CKD成年人（689名男性和935名女性）以及200名正常对照者。所有招募的受试者均接受了体重指数（BMI）、血清尿素氮、肌酐、钙（Ca）、磷（P）、甲状旁腺激素（PTH）、25羟维生素D（25(OH)D）、白蛋白和尿酸（UA）水平的检测；尿白蛋白/肌酐比值（ACR）以及估算肾小球滤过率的检测。仅1.4%的CKD患者维生素D水平处于最佳范围，而正常对照者中这一比例为52%。共有1107例（68.2%）CKD患者血清25(OH)D <20 ng/mL，而对照组为23例（11.5%）（CKD组与对照组的均值±标准差分别为16.8 ± 5.8与37.3±7.6 ng/mL，P <0.001）。血清25(OH)D与血清Ca之间存在高度统计学意义的正相关（r = 0.299，P <0.001），而血清25(OH)D一方面与血清P、血清PTH、血清UA以及另一方面与尿ACR之间存在高度统计学意义的负相关（r分别为 -0.46、-0.69、-0.73和 -0.8，P <0.001）。维生素D缺乏症在埃及CKD患者中非常普遍。血清P、UA以及尿ACR比值是发现与血清25(OH)D呈负相关的最重要变量。
