Publication: Vitamin D and parathyroid hormone status in community-dwelling elderly patients with mild-to-moderate kidney impairment
Issued Date
2021-05-01
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ISSN
15732584
03011623
03011623
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2-s2.0-85098960925
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Mahidol University
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SCOPUS
Bibliographic Citation
International Urology and Nephrology. Vol.53, No.5 (2021), 973-983
Suggested Citation
Nipith Charoenngam, Sutin Sriussadaporn Vitamin D and parathyroid hormone status in community-dwelling elderly patients with mild-to-moderate kidney impairment. International Urology and Nephrology. Vol.53, No.5 (2021), 973-983. doi:10.1007/s11255-020-02695-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78268
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Title
Vitamin D and parathyroid hormone status in community-dwelling elderly patients with mild-to-moderate kidney impairment
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Abstract
Introduction: Evidence on vitamin D and parathyroid hormone (PTH) status in patients with early kidney impairment is limited. We aimed to determine the associations among kidney function, vitamin D, and PTH status in community-dwelling elderly patients with mild-to-moderate kidney impairment. Methods: Community-dwelling elderly patients were enrolled in this Institutional Review Board approved cross-sectional study. The eligibility criteria were as follows: age > 60 years, no recent hospitalization within the past 12 months, no conditions that affect vitamin D status including vitamin D supplementation, and eGFR > 30 mL/min/1.73 m2. Serum 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) levels were assessed. Results: A total of 226 patients were enrolled. Data were expressed as mean ± SD. The mean serum 25(OH)D was 26.61 ± 10.44 ng/mL and the mean serum PTH was 50.67 ± 22.67 pg/mL. The prevalence of vitamin D deficiency [25(OH)D < 20 ng/mL] and secondary hyperparathyroidism [PTH > 65 pg/mL] were 25.3% and 18.1%, respectively. Patients with eGFR 30− < 60 mL/min/1.73m2 had significantly higher prevalence of 25(OH)D < 20 ng/mL (33.7% versus 19.4%, p < 0.05) than patients with eGFR ≥ 60 mL/min/1.73 m2. Multiple regression analysis showed independent negative association of serum PTH level with eGFR (mL/min/1.73 m2, β: − 0.261, 95% CI [− 0.408, − 0.114]) and serum 25(OH)D (ng/mL, β: − 0.499, 95% CI [− 0.775, − 0.223], adjusted for possible confounders). Conclusions: The prevalence of vitamin D deficiency was higher in patients with eGFR 30 – < 60 mL/min/1.73 m2 than those with eGFR ≥ 60 mL/min/1.73 m2. Both decreased serum 25(OH)D levels and decreased eGFR were independently associated with increased serum PTH levels among these patients.