Fatores associados à hipovitaminose D na doença renal crônica / Risk factors for hypovitaminosis D in nondialyzed chronic kidney disease patients

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Background: Hypovitaminosis D is highly prevalent among chronic kidney disease patients and it has been associated with worse outcome even in the earlier stages of the disease. Objective: This study aimed to investigate the risk factors for hypovitaminosis D in nondialyzed chronic kidney disease patients. Design: This cross-sectional study included 120 chronic kidney disease patients on stages 2 to 5 (62% male, age 55.4}11.3yr, estimated glomerular filtration rate 35.1}15ml/min, body mass index (BMI) 27.1}5.2kg/m2, 31% diabetics). Serum 25-hydroxivitamin D was measured by chemiluminescence. Subjective global assessment, total body fat (dual-energy X-ray absorptiometry), visceral and subcutaneous abdominal fat (computed tomography) and several laboratory parameters were assessed. Results: Insufficiency of 25-hydroxivitamin D (15-30ng/ml) was observed in 55% of the patients and deficiency (<15ng/ml) in 20%. Patients with diabetes, BMI .30kg/m2, and who had the blood collection during the winter or spring had lower 25-hydroxivitamin D levels. Serum 25-hydroxivitamin D correlated inversely with parathyroid hormone, proteinuria, insulin resistance, leptin, and subcutaneous abdominal fat. The risk factors for hypovitaminosis D were diabetes (odds ratio 3.8; 95% CI 1.2-11.7; P=0.022) and BMI .30kg/m2 (odds ratio 4.3; 95% CI 1.2-15.3; P=0.018). In the logistic regression analysis adjusting for gender, skin color and season of the year, diabetes and BMI .30kg/m2 were independently associated with hypovitaminosis D. Conclusions: Diabetes and obesity were the risk factors for hypovitaminosis D in nondialyzed chronic kidney disease patients. Effective interventional protocols of vitamin D supplementation taking into account these risk factors are warranted for this population.

ASSUNTO(S)

hipovitaminose d 25-hidroxivitamina d diabetes obesidade doença renal crônica nutricao hypovitaminosis d 25-hydroxivitamin d diabetes obesity chronic kidney disease

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