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Loss via peritoneal fluid as a factor for low 25(OH)D3 level in peritoneal dialysis patients

  • Nephrology - Original Paper
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Abstract

Background/aims

In patients with end-stage renal disease (ESRD), the 25-hydroxyvitamin D3 (25(OH)D3) level is known to be lower compared to that of the normal population. In the present study, we evaluated the influences of dialysis methods on the serum 25(OH)D3 level in patients with ESRD who are treated with hemodialysis and peritoneal dialysis.

Methods

Thirty-nine peritoneal dialysis (PD), 49 hemodialysis (HD) patients, and 33 healthy controls were included in the present study. The mean HD period was 30.38 ± 21.81 months and the mean PD period was 26.35 ± 24.04 months. Serum samples from the HD and PD patients and healthy controls were examined in terms of 25(OH)D3, intact parathyroid hormone (iPTH), and other biochemical laboratory tests. Additionally, the 25(OH)D3 level in the peritoneal fluid was analyzed in the PD group.

Results

The mean 25(OH)D3 levels in the control, HD, and PD groups were 26.63 ± 10.89, 21.65 ± 12.38, and 13.46 ± 9.41 nmol/l, respectively (P < 0.001). The mean peritoneal fluid 25(OH)D3 level was 28.53 ± 7.66 nmol/l. Moreover, blood and PD fluid 25(OH)D3 levels were 34 compared in the PD group. The 25(OH)D3 level in dialysate was higher than that of serum in PD patients (P < 0.001).

Conclusion

The significantly lower blood levels of 25(OH)D3 in PD patients compared to those of HD patients were thought to be due to 25(OH)D3 loss via peritoneal fluid.

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References

  1. Holick MF (2003) Vitamin D: a millenium perspective. J Cell Biochem 88(2):296–307. doi:10.1002/jcb.10338

    Article  CAS  PubMed  Google Scholar 

  2. MacLaughlin J, Holick MF (1985) Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 76(4):1536–1538. doi:10.1172/JCI112134

    Article  CAS  PubMed  Google Scholar 

  3. Zittermann A (2003) Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr 89(5):552–572. doi:10.1079/BJN2003837

    Article  CAS  PubMed  Google Scholar 

  4. Lips P (2006) Vitamin D physiology. Prog Biophys Mol Biol 92(1):4–8. doi: 10.1016/j.pbiomolbio.2006.02.016

    Article  CAS  PubMed  Google Scholar 

  5. National Kidney Foundation (2003) K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 42(4 Suppl 3):7–201

    Google Scholar 

  6. Saha H (1994) Calcium and vitamin D homeostasis in patients with heavy proteinuria. Clin Nephrol 41:290–296

    CAS  PubMed  Google Scholar 

  7. Koenig KG, Lindberg JS, Zerwekh JE, Padalino PK, Cushner HM, Copley JB (1992) Free and total 1,25-dihydroxyvitamin D levels in subjects with renal disease. Kidney Int 41(1):161–165. doi:10.1038/ki.1992.22

    Article  CAS  PubMed  Google Scholar 

  8. Thomas MK, Lloyd-jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM, Prince RL, Finkelstein JS (1998) Hypovitaminosis D in medical inpatients. N Engl J Med 338(12):777–783. doi:10.1056/NEJM199803193381201

    Article  CAS  PubMed  Google Scholar 

  9. LaClair RE, Hellman RN, Karp SL, Kraus M, Ofner S, Li Q, Graves KL, Moe SM (2005) Prevalence of calcidiol deficiency in CKD: a cross-sectional study across latitudes in the United States. Am J Kidney Dis 45(6):1026–1033. doi:10.1053/j.ajkd.2005.02.029

    Article  CAS  PubMed  Google Scholar 

  10. González EA, Sachdeva A, Oliver DA, Martin KJ (2004) Vitamin D insufficiency and deficiency in chronic kidney disease. a single center observational study. Am J Nephrol 24(5):503–510. doi:10.1159/000081023

    Article  PubMed  Google Scholar 

  11. Shah N, Bernardini J, Piraino B (2005) Prevalence and correction of 25(OH) vitamin D deficiency in peritoneal dialysis patients. Perit Dial Int 25(4):362–366

    CAS  PubMed  Google Scholar 

  12. Taskapan H, Ersoy FF, Passadakis PS, Tam P, Memmos DE, Katopodis KP, Ozener C, Akcicek F, Camsari T, Ates K, Ataman R, Vlachojannis JG, Dombros NA, Utas C, Akpolat T, Bozfakioglu S, Wu G, Karayaylali I, Arinsoy T, Stathakis CP, Yavuz M, Tsakiris DJ, Dimitriades AD, Yilmaz ME, Gültekin M, Oreopoulos DG (2006) Severe vitamin D deficiency in chronic renal failure patients on peritoneal dialysis. Clin Nephrol 66(4):247–255

    CAS  PubMed  Google Scholar 

  13. Gokal R, Ramos JM, Ellis HA, Parkinson I, Sweetman V, Dewar J, Ward MK, Kerr DN (1983) Histological renal osteodystrophy, and 25 hydroxycholecalciferol and aluminum levels in patients on continuous ambulatory peritoneal dialysis. Kidney Int 23(1):15–21. doi:10.1038/ki.1983.4

    Article  CAS  PubMed  Google Scholar 

  14. Aloni Y, Shany S, Chaimovitz C (1983) Losses of 25-hydroxyvitamin D in peritoneal fluid: possible mechanism for bone disease in uremic patients treated with chronic ambulatory peritoneal dialysis. Miner Electrolyte Metab 9(2):82–86

    CAS  PubMed  Google Scholar 

  15. Zucchelli P, Catizone L, Casanova S, Fusaroli M, Fabbri L, Ferrari G (1984) Renal osteodystrophy in CAPD patients. Miner Electrolyte Metab 10(5):326–332

    CAS  PubMed  Google Scholar 

  16. Hart GR, Furniss JL, Laurie D, Durham SK (2006) Measurement of vitamin D status: background, clinical use, and methodologies. Clin Lab (Zaragoza) 52(7–8):335–343

    CAS  Google Scholar 

  17. Hyppönen E, Turner S, Cumberland P, Power C, Gibb I (2007) Serum 25-hydroxyvitamin D measurement in a large population survey with statistical harmonization of assay variation to an international standard. J Clin Endocrinol Metab 92(12):4615–4622. doi:10.1210/jc.2007-1279

    Article  PubMed  Google Scholar 

  18. Eastwood JB, Stamp TC, Harris E, de Wardener HE (1976) Vitamin-D deficiency in the osteomalacia of chronic renal failure. Lancet 2(7997):1209–1211. doi:10.1016/S0140-6736(76)91140-5

    Article  CAS  PubMed  Google Scholar 

  19. Lafage MH, Combe C, Fournier A, Aparicio M (1992) Ketodiet, physiological calcium intake and native vitamin D improve renal osteodystrophy. Kidney Int 42(5):1217–1225. doi:10.1038/ki.1992.407

    Article  CAS  PubMed  Google Scholar 

  20. Ghazali A, Fardellone P, Pruna A, Atik A, Achard JM, Oprisiu R, Brazier M, Remond A, Morinière P, Garabedian M, Eastwood J, Fournier A (1999) Is low plasma 25-(OH)vitamin D a major risk factor for hyperparathyroidism and Looser’s zones independent of calcitriol? Kidney Int 55(6):2169–2177. doi:10.1046/j.1523-1755.1999.00480.x

    Article  CAS  PubMed  Google Scholar 

  21. Mucsi I, Almási C, Deák G, Marton A, Ambrus C, Berta K, Lakatos P, Szabó A, Horváth C (2005) Serum 25(OH)-vitamin D levels and bone metabolism in patients on maintenance hemodialysis. Clin Nephrol 64(4):288–294

    CAS  PubMed  Google Scholar 

  22. Delmez JA, Slatopolsky E, Martin KJ, Gearing BN, Harter HR (1982) Minerals, vitamin D, and parathyroid hormone in continuous ambulatory peritoneal dialysis. Kidney Int 21(6):862–867. doi:10.1038/ki.1982.110

    Article  CAS  PubMed  Google Scholar 

  23. Kurtz SB, McCarthy JT, Kumar R (1981) Hypercalcemia in continuous ambulatory peritoneal dialysis (CAPD) patients: observations on parameters of calcium metabolism. In: Gahl GM, Kessel M, Nolph KD (eds) Advances in peritoneal dialysis. Excerpta Medica, Amsterdam, pp 467–472

    Google Scholar 

  24. Cassidy MJ, Owen JP, Ellis HA, Dewar J, Robinson CJ, Wilkinson R, Ward MK, Kerr DN (1985) Renal osteodystrophy and metastatic calcification in long-term continuous ambulatory peritoneal dialysis. Q J Med 54(213):29–48

    CAS  PubMed  Google Scholar 

  25. Holick MF (1987) Vitamin D and the kidney. Kidney Int 32(6):912–929. doi:10.1038/ki.1987.295

    Article  CAS  PubMed  Google Scholar 

  26. Taskapan H, Wei M, Oreopoulos DG (2006) 25(OH) vitamin D3 in patients with chronic kidney disease and those on dialysis: rediscovering its importance. Int Urol Nephrol 38(2):323–329. doi:10.1007/s11255-006-0081-7

    Article  CAS  PubMed  Google Scholar 

  27. Spasovski GB (2007) Bone health and vascular calcification relationships in chronic kidney disease. Int Urol Nephrol 39(4):1209–1216. doi:10.1007/s11255-007-9276-9

    Article  CAS  PubMed  Google Scholar 

  28. Gelev S, Spasovski GB, Dzikova S, Trajkovski Z, Damjanovski G, Amitov V, Sikole A (2008) Vascular calcification and atherosclerosis in hemodialysis patients: what can we learn from the routine clinical practice? Int Urol Nephrol 40:763–770. doi:10.1007/s11255-008-9379-y

    Article  CAS  PubMed  Google Scholar 

  29. Kovesdy CP, Kalantar-Zadeh K (2008) Bone and mineral disorders in pre-dialysis CKD. Int Urol Nephrol 40:427–440. doi:10.1007/s11255-008-9346-7

    Article  PubMed  Google Scholar 

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Correspondence to Garip Sahin.

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Sahin, G., Kirli, I., Sirmagul, B. et al. Loss via peritoneal fluid as a factor for low 25(OH)D3 level in peritoneal dialysis patients. Int Urol Nephrol 41, 989–996 (2009). https://doi.org/10.1007/s11255-009-9561-x

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  • DOI: https://doi.org/10.1007/s11255-009-9561-x

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