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Incident isolated 1,25(OH)2D3 deficiency is more common than 25(OH)D deficiency in CKD.
MedLine Citation:
PMID:  21688248     Owner:  NLM     Status:  Publisher    
Introduction: Vitamin D deficiencies are well described in general populations and in those with chronic kidney disease (CKD). Although serum 25(OH)D may be a good indicator of vitamin D status in healthy individuals, the hydroxylated product, 1,25(OH)2D, essential for important biological functions such as mineral metabolism, bone turnover, regulation of protein synthesis, cell differentiation and proliferation may be a more suitable indicator for individuals with CKD. Methods: We report an observational prospective cohort study of the incidence after 12 months of new isolated 1,25(OH)2D and new 25(OH)D deficiency in CKD patients (estimated glomerular filtration rate [eGFR] <60 ml/min), who were vitamin D replete at baseline. All analyses were run in a central laboratory. Results: Of 1,256 patients who completed the study at 12 months, 631 were replete in both 25(OH)D and 1,25(OH)2D at baseline; at 12 months, 65% remained replete, 25% developed an isolated 1,25(OH)2D deficiency, whereas only 6% developed an isolated 25(OH)D deficiency. Based on the multinomial logistic regression model, factors that were associated with 12-month changes in vitamin D status were diabetes, baseline values of eGFR, albumin and both 25(OH)D and 1,25(OH)2D (all p values <0.03). Patients with diabetes, lower albumin, lower eGFR, lower levels of 25(OH)D and 1,25(OH)2D at baseline were at increased risk of developing isolated 1,25(OH)2D deficiency. Conclusions: The high incidence of new isolated 1,25(OH)2D deficiency as compared with new 25(OH)D deficiency, in the presence of 25(OH)D sufficiency, brings into question the value of measuring 25(OH)D levels in CKD. The significance of these findings and implications for replacement strategies require further study.
Adeera Levin; Melina Le Barbier; Lee Er; Dennis Andress; Mhairi K Sigrist; Ognjenka Djurdjev
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-16
Journal Detail:
Title:  Journal of nephrology     Volume:  -     ISSN:  1724-6059     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9012268     Medline TA:  J Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
BC Provincial Renal Agency, Vancouver, British Columbia - Canada and Division of Nephrology, University of British Columbia, Vancouver, British Columbia - Canada.
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