Sattar Sidra, Adnan Farzana, Waheed Shahid
Department of Medical Education, Aga Khan University Hospital, Karachi, Pakistan.
Department of Nephrology, Liaquat National Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2020 Dec;70(12(A)):2190-2194. doi: 10.47391/JPMA.479.
To assess the frequency of Vitamin D Deficiency and its association with serum Parathormone (PTH) levels in End stage renal disease patients in a tertiary setup.
This cross sectional study was conducted in the Department of Nephrology, Liaquat National Hospital from January to December 2016 and comprised patients with End stage renal disease on maintenance haemodialysis. Sample size of 113 at 8% prevalence was calculated inflated to 150. Participants were selected through purposive sampling technique. Numerical variables were expressed as mean ± SD (standard deviation) while categorical variables were expressed as frequency and percentages. To determine association between Vitamin D and serum Parathormone (PTH) levels chi-square test was applied. Association of serum alkaline phosphatase levels with both Vitamin D levels and PTH levels was analyzed using chi-square test. SPSS 20 was used for data analysis. P-value <0.05 was taken as significant.
Of the 150 participants, 33 were drop outs, 63(53.8%) were males and 54(46.2%) were females. The overall mean age was 52.47±15.21 years. Of all, hypertension as a comorbidity was present in 64(54.7%), Diabetes mellitus was present in 8(6.8%) and cardiovascular disease in 7(6%). Among the biochemical markers, mean serum vitamin D levels were 18.6±13.6ng/ml, mean Serum PTH levels were 253.8±227.2pg/ml, mean serum alkaline phosphatase levels were 143.7±125.4μg/L, mean serum phosphorus levels were 4.81±3.46mg/dl and mean serum calcium levels were 21.41±114.4mg/dl. Among the study participants, 67(57.3%) were found to be Vitamin D deficient. Both low and normal vitamin D was associated with High PTH (P <0.001) Other significant associations noted were that of High Alkaline Phosphatase with High PTH levels and a normal Vitamin D level (P<0.001).
Our study revealed more than half of our participants were Vitamin D deficient and an association was found between Normal Vitamin D levels and high serum PTH levels with associated high alkaline phosphatase levels.
评估三级医疗机构中终末期肾病患者维生素D缺乏的发生率及其与血清甲状旁腺激素（PTH）水平的关系。
本横断面研究于2016年1月至12月在利亚卡特国家医院肾脏病科进行，纳入维持性血液透析的终末期肾病患者。按8%的患病率计算样本量为113例，扩大至150例。采用目的抽样技术选取参与者。数值变量以均数±标准差（SD）表示，分类变量以频数和百分比表示。应用卡方检验确定维生素D与血清甲状旁腺激素（PTH）水平之间的关联。使用卡方检验分析血清碱性磷酸酶水平与维生素D水平和PTH水平的关联。采用SPSS 20进行数据分析。P值<0.05被视为具有统计学意义。
150名参与者中，33人退出研究，63名（53.8%）为男性，54名（46.2%）为女性。总体平均年龄为52.47±15.21岁。其中，64名（54.7%）患有高血压合并症，8名（6.8%）患有糖尿病，7名（6%）患有心血管疾病。在生化指标中，血清维生素D平均水平为18.6±13.6ng/ml，血清PTH平均水平为253.8±227.2pg/ml，血清碱性磷酸酶平均水平为143.7±125.4μg/L，血清磷平均水平为4.81±3.46mg/dl，血清钙平均水平为21.41±114.4mg/dl。在研究参与者中，67名（57.3%）被发现维生素D缺乏。维生素D水平低和正常均与高PTH相关（P<0.001）。其他显著关联包括高碱性磷酸酶与高PTH水平以及正常维生素D水平相关（P<0.001）。
我们的研究表明，超过一半的参与者维生素D缺乏，且发现正常维生素D水平与高血清PTH水平以及相关的高碱性磷酸酶水平之间存在关联。
