scholarly journals Significant Independent Predictors of Vitamin D Deficiency in Inpatients and Outpatients of a Nephrology Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Recep Bentli ◽  
Hulya Taskapan ◽  
Halil Toktaş ◽  
Ozkan Ulutas ◽  
Adnan Ozkahraman ◽  
...  

Aims. Kidney disease was found to be a major risk factor for vitamin D deficiency in a population study of patients hospitalized. The aims of the study were to describe the prevalence of vitamin D deficiency inpatients and outpatients in a nephrology department during fall and to evaluate effect of assessing serum 25-hydroxyvitamin D (25(OH)D) levels and previous supplementation of cholecalciferol on vitamin D status.Methods. We studied 280 subjects in total, between October and January. The subjects were recruited from the following two groups: (a) inpatients and (b) outpatients in nephrology unit. We examined previous documentary evidence of vitamin D supplementation of the patients.Results. The prevalence of vitamin D deficiency among these 280 patients was 62,1% (174 patients). Fifty-three patients (18.9%) had severe vitamin D deficiency, 121 patients (43.2%) moderate vitamin D deficiency, and 66 patients (23.6%) vitamin D insufficiency. In logistic regression analysis female gender, not having vitamin D supplementation history, low serum albumin, and low blood urea nitrogen levels were significant independent predictors of vitamin D deficiency while no association of vitamin D deficiency with diabetes mellitus, serum creatinine, eGFR, and being hospitalized was found.Conclusion. Vitamin D deficiency, seems to be an important problem in both inpatients and outpatients of nephrology. Monitoring serum 25(OH)D concentrations regularly and replacement of vitamin D are important. Women in Turkey are at more risk of deficiency and may therefore need to consume higher doses of vitamin D.

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Naowanit Nata ◽  
Jessada Kanchanasinitth ◽  
Pamila Tasanavipas ◽  
Ouppatham Supasyndh ◽  
Bancha Satirapoj

Background. Vitamin D deficiency is a common problem among patients on continuous ambulatory peritoneal dialysis (CAPD). Vitamin D supplementation leads to reduced serum parathyroid hormone levels and improved cardiovascular markers. Different doses and time intervals of oral vitamin D supplementation may differ in each patient on dialysis. The study aimed to evaluate the efficacy of weekly split and single dose of ergocalciferol at 60,000 IU on serum 25-hydroxyvitamin D (25(OH)D) among patients on CAPD. Methods. A randomized study was conducted among patients on CAPD with vitamin D deficiency or insufficiency (25(OH)D < 30 ng/mL). Patients were randomly assigned to two groups: the split dose group was given ergocalciferol 20,000 IU three times weekly and the single dose group was given ergocalciferol 60,000 IU once weekly for 8 weeks. Main outcomes measured serum 25(OH)D concentrations, serum calcium, serum phosphate, and intact parathyroid levels at 8 weeks after being enrolled. Results. Of 128 screened patients, 50 met the criteria for eligibility and were randomized. At 8 weeks after treatment, mean serum 25(OH)D concentrations significantly increased from baseline 22.7 ± 5.9 to 29.5 ± 9.5 ng/mL P = 0.004 in the split dose group and 22.9 ± 5.3 to 31.2 ± 12.3 ng/mL P = 0.003 in the single dose group. No significant change was found in increase of serum 25(OH)D between the two groups P = 0.561 . At the end of study, a similar proportion of patients in both groups reached the desirable serum concentration of 25(OH)D ≥ 30 ng/mL (60% in the single group vs. 40% in the split group, P = 0.258 ). No significant cases of hypercalcemia, hyperphosphatemia, or serious adverse events occurred during the study. Conclusion. Weekly single and split doses of ergocalciferol 60,000 IU achieved similar effects on serum 25(OH)D levels among patients on CAPD with vitamin D insufficiency or deficiency, suggesting that weekly single dose would be prescribed for adequate vitamin D repletion. This trial is registered with TCTR20200821005.


2015 ◽  
Vol 18 (02) ◽  
pp. 1550008 ◽  
Author(s):  
Negin Masoudi Alavi ◽  
Mahla Madani ◽  
Mohsen Taghizadeh ◽  
Mohammad Reza Sharif

Purpose: To investigate the effect of weekly single high dose vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D], and non-specific musculoskeletal pain in female nurses. Methods: In this prospective study in Kashan/Iran, from April 1, 2014, through September 30, 2014, the 150 nurses with vitamin D deficiency received the weekly pearls of 50,000 units of vitamin D3 for 10 weeks. The serum level of 25(OH)D was measured before and after supplement therapy. The subjects were also asked to complete the Extended Nordic Musculoskeletal Questionnaire. All analyses were conducted with SPSS version 16. Results: After 10 weeks of intervention there was [Formula: see text][Formula: see text]ng/mL increase in 25(OH)D. The 82 nurses (54.7%) had 25(OH)D in normal range, while the 68 nurses (45.3%) were still vitamin D deficient. Weight could explain 15.4% increase in 25(OH)D. Before intervention 135 (90%), of nurses reported musculoskeletal pain in at least one region, after intervention this number decreased to 72.7%. There was a statistically significant improvement in musculoskeletal pain in neck, shoulders, upper back, lower back, hips/tights, knees, and ankles/feet after intervention. Conclusions: The weekly single high dose of vitamin D for 10 weeks could resolve vitamin D deficiency in about half of the patients. Patients with non-specific musculoskeletal pain might benefit from vitamin D supplementation.


2018 ◽  
Vol 40 (4) ◽  
pp. 1109-1151 ◽  
Author(s):  
Roger Bouillon ◽  
Claudio Marcocci ◽  
Geert Carmeliet ◽  
Daniel Bikle ◽  
John H White ◽  
...  

AbstractThe etiology of endemic rickets was discovered a century ago. Vitamin D is the precursor of 25-hydroxyvitamin D and other metabolites, including 1,25(OH)2D, the ligand for the vitamin D receptor (VDR). The effects of the vitamin D endocrine system on bone and its growth plate are primarily indirect and mediated by its effect on intestinal calcium transport and serum calcium and phosphate homeostasis. Rickets and osteomalacia can be prevented by daily supplements of 400 IU of vitamin D. Vitamin D deficiency (serum 25-hydroxyvitamin D <50 nmol/L) accelerates bone turnover, bone loss, and osteoporotic fractures. These risks can be reduced by 800 IU of vitamin D together with an appropriate calcium intake, given to institutionalized or vitamin D–deficient elderly subjects. VDR and vitamin D metabolic enzymes are widely expressed. Numerous genetic, molecular, cellular, and animal studies strongly suggest that vitamin D signaling has many extraskeletal effects. These include regulation of cell proliferation, immune and muscle function, skin differentiation, and reproduction, as well as vascular and metabolic properties. From observational studies in human subjects, poor vitamin D status is associated with nearly all diseases predicted by these extraskeletal actions. Results of randomized controlled trials and Mendelian randomization studies are supportive of vitamin D supplementation in reducing the incidence of some diseases, but, globally, conclusions are mixed. These findings point to a need for continued ongoing and future basic and clinical studies to better define whether vitamin D status can be optimized to improve many aspects of human health. Vitamin D deficiency enhances the risk of osteoporotic fractures and is associated with many diseases. We review what is established and what is plausible regarding the health effects of vitamin D.


2003 ◽  
Vol 88 (11) ◽  
pp. 5175-5179 ◽  
Author(s):  
Franck Grados ◽  
Michel Brazier ◽  
Saïd Kamel ◽  
Marc Mathieu ◽  
Nathalie Hurtebize ◽  
...  

Abstract The aim of this study was to determine whether early changes in bone markers could predict long-term response in bone mineral density (BMD) after calcium (500 mg) and vitamin D (400 IU) supplementation twice daily in ambulatory elderly women with vitamin D insufficiency (25-hydroxyvitamin D, &lt;12 ng/ml). One hundred and ninety-two women (mean age, 75 ± 7 yr) were randomized to receive either the supplementation (n = 95) or a placebo (n = 97) in a double-blind, controlled clinical trial for 1 yr. In comparison with the placebo group, supplementation significantly increased BMD, normalized 25-hydroxyvitamin D and significantly decreased intact PTH and bone remodeling markers. The initial values of telopeptide cross-links were correlated with improvement in total body BMD [urinary N-telopeptides (NTX), r = 0.38; C-telopeptides (CTX), r = 0.32; serum CTX, r = 0.28], and the 3-month changes in the same markers were correlated with improvement in total body (urinary N-telopeptides, r = −0.29; serum CTX, r = −0.26) and vertebral BMD (CTX, r = −0.26; all P &lt; 0.05). We concluded that short-term changes in bone resorption markers can predict long-term variations in BMD in elderly women with vitamin D insufficiency receiving calcium and vitamin D supplementation.


2008 ◽  
Vol 99 (6) ◽  
pp. 1330-1334 ◽  
Author(s):  
Jean Woo ◽  
Christopher W. K. Lam ◽  
Jason Leung ◽  
Winny Y. Lau ◽  
Edith Lau ◽  
...  

We aimed to describe the vitamin D status of young women living in two Chinese cities in the spring – Beijing in the north (latitude 39° north) and Hong Kong (latitude 22° north) in the south. We also examined the relationship between serum 25-hydroxyvitamin D and parathyroid hormone (PTH) concentrations to determine a threshold for serum 25-hydroxyvitamin D above which there is no further suppression of PTH. Finally, we examined whether dietary Ca intake influences this relationship. Non-pregnant women aged 18–40 years (n 441) were recruited between February and June. Fasting blood was collected and dietary intakes were assessed using 5 d food records. Mean serum 25-hydroxyvitamin D concentration was lower in Beijing than Hong Kong women (29 v. 34 nmol/l; P < 0·001). Vitamin D deficiency ( ≤  25 nmol/l) was indicated in 40 % of Beijing and 18 % of Hong Kong women, and over 90 % of women in both cities were insufficient ( ≤ 50 nmol/l). Mean Ca and vitamin D intakes were 478 mg/d and 2·0 μg/d, respectively. The relationship between 25-hydroxyvitamin D concentration and PTH was linear throughout the range with a slope of − 0·36 (different from 0; P < 0·001; R 0·26), with no apparent threshold. There was no influence of Ca intake on the relationship between 25-hydroxyvitamin D and PTH concentration. Vitamin D deficiency is common and insufficiency is very common in non-pregnant women in Hong Kong and Beijing during spring. Serum 25-hydroxyvitamin D was inversely associated with PTH with no apparent threshold. Strategies such as vitamin D fortification or supplementation may be required.


Author(s):  
Gal Dubnov-Raz ◽  
Netachen Livne ◽  
Raanan Raz ◽  
Avner H. Cohen ◽  
Naama W. Constantini

It is hypothesized that vitamin D insufficiency in athletes might negatively affect sport performance. The objective of this study was to examine the effect of vitamin D3 supplementation on physical performance of adolescent swimmers with vitamin D insufficiency. Fifty-three adolescent competitive swimmers with vitamin D insufficiency (serum 25-hydroxyvitamin-D concentrations (25(OH)D)<30ng/ml, mean 24.2 ± 4.8ng/ml) were randomized to receive 2,000IU/day of vitamin D3 or placebo for 12 weeks. Swimming performance at several speeds, arm-grip strength, and one-legged balance, were measured before and after supplementation. The age-adjusted changes in performance variables during the study were compared between groups. 25(OH) D concentrations at study end were significantly higher in the vitamin group compared with the placebo group (29.6 ± 6.5ng/ml vs. 20.3 ± 4.2ng/ml, p < .001), yet only 48% of the vitamin group became vitamin D sufficient with this dosing. No between-group differences were found in the changes of the performance variables tested. No significant differences in performance were found between participants that became vitamin D sufficient, and those who did not. No significant correlation was found between the change in serum 25(OH)D and ageadjusted balance, strength or swimming performance at study end. Vitamin D3 supplementation that raised serum 25(OH)D concentrations by a mean of 9.3ng/ml above placebo in adolescent swimmers with vitamin D insufficiency, did not improve physical performance more than placebo.


2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Aashima Dabas ◽  
T. Aravind ◽  
Sangeeta Yadav ◽  
Mukta Mantan ◽  
Smita Kaushik

Objectives: Obesity has been mentioned as a high risk factor for Vitamin D deficiency (VDD) requiring supplementation in Indian children. Material and Methods: Forty obese and age-matched non-obese subjects (age 5–18 years) were assessed for lifestyle parameters, metabolic profile, and serum 25-hydroxyvitamin D (25OHD). VDD was defined as serum 25OHD < 12 ng/mL. Results: Mean 25OHD was comparable among obese and controls (15.0 ± 9.95 and 15.1 ± 4.79 ng/mL; P = 0.97) with VDD seen in 82% of cases and 85% of controls. Pubertal cases had lower 25OHD values than prepubertal obese cases (10.78 ± 4.69 and 17.2 ± 11 ng/mL; P = 0.06). Mean duration of physical activity (<2 h/week) and screen time (>2 h/day) was similar across prepubertal and pubertal groups and between obese and controls. Obesity was not associated with risk for VDD among cases and controls (odds ratio 0.83, 95% C.I. 0.25–2.7, P = 0.76). Conclusion: Obese pubertal subjects were more at risk for VDD than prepubertal subjects. Routine Vitamin D supplementation to obese Indian children may be considered during adolescence.


2016 ◽  
Vol 3 (2) ◽  
pp. 128
Author(s):  
Jeetendra Singh ◽  
Sameer B. Dharrao ◽  
Tushar Baheti

In the beginning of 20<sup>th</sup> century vitamin D was classified as a vitamin but later considered as a prohormone ("conditional" vitamin) which influences the expression of more than 200 genes in the human body. Worldwide vitamin D insufficiency affects about 50% of the population and in India about 80% of population has vitamin D level less than normal. In India sunshine is abundant but still Indians are deprived of this sunshine vitamin. Minimal exposure to direct sunlight, staying indoors, use of sunscreen lotions, pollution, clothing, dietary and cooking habits are most important factors for vitamin D deficiency in the Indian population. Serum 25 hydroxyvitamin D level is the initial diagnostic test in patients at risk for deficiency. Treatment with either vitamin D<sub>2</sub> or vitamin D<sub>3</sub> is recommended for patients having deficiency, keeping hypervitaminosis in mind.


2014 ◽  
Vol 18 (3) ◽  
pp. 554-561 ◽  
Author(s):  
Pascal Caillet ◽  
Susan B Jaglal ◽  
Laurent Laforest ◽  
Roland Chapurlat ◽  
Muriel Rabilloud ◽  
...  

AbstractObjectiveChronic vitamin D deficiency has been associated in some patients with diffuse musculoskeletal pain. These unspecific symptoms may partly explain why vitamin D deficiency is often diagnosed late. Our aim was to analyse health-care claims after vitamin D supplementation in patients likely to have vitamin D deficiency.DesignAmbulatory health-care claims were compared before and after a vitamin D supplementation prescribed following a 25-hydroxyvitamin D assay.SettingHealth Insurance Fund (FHIF) database of the Rhône-Alpes area, France.SubjectsAmong patients reimbursed for a 25-hydroxyvitamin D assay between 1 December 2008 and 31 January 2009, those supplemented with vitamin D after the assay were matched on the date of assay to patients who did not receive vitamin D.ResultsAmong the 3023 patients who had a 25-hydroxyvitamin D assay, 935 were consequently supplemented and matched to 935 patients not supplemented. Their median age was 50·0 and 49·5 years, respectively. Patients supplemented decreased their muscle relaxant consumption whereas no change was observed in the reference group, the difference between the two groups was significant (P=0·03). Second and third Pain Relief Ladder prescriptions decreased in both groups but not significantly differently between groups (P=0·58). There was a decrease in prescriptions of biological examination in both groups with no significant difference.ConclusionsBesides a decrease in muscle relaxant prescriptions in the supplemented group, it was difficult to assess the impact of vitamin D supplementation in patients likely to have vitamin D deficiency. Prospective cohort studies and randomized trials are needed to assess the efficiency of screening and supplementing vitamin D deficiency.


2013 ◽  
Vol 110 (10) ◽  
pp. 1866-1872 ◽  
Author(s):  
Sara R. Zwart ◽  
Howard Parsons ◽  
Michael Kimlin ◽  
Sheila M. Innis ◽  
James P. Locke ◽  
...  

The risk of vitamin D insufficiency is increased in persons having limited sunlight exposure and dietary vitamin D. Supplementation compliance might be improved with larger doses taken less often, but this may increase the potential for side effects. The objective of the present study was to determine whether a weekly or weekly/monthly regimen of vitamin D supplementation is as effective as daily supplementation without increasing the risk of side effects. Participants were forty-eight healthy adults who were randomly assigned for 3 months to placebo or one of three supplementation regimens: 50 μg/d (2000 IU/d, analysed dose 70 μg/d), 250 μg/week (10 000 IU/week, analysed dose 331 μg/week) or 1250 μg/week (50 000 IU/week, analysed dose 1544 μg/week) for 4 weeks and then 1250 μg/month for 2 months. Daily and weekly doses were equally effective at increasing serum 25-hydroxyvitamin D, which was significantly greater than baseline in all the supplemented groups after 30 d of treatment. Subjects in the 1250 μg treatment group, who had a BMI >26 kg/m2, had a steady increase in urinary Ca in the first 3 weeks of supplementation, and, overall, the relative risk of hypercalciuria was higher in the 1250 μg group than in the placebo group (P= 0·01). Although vitamin D supplementation remains a controversial issue, these data document that supplementing with ≤ 250 μg/week ( ≤ 10 000 IU/week) can improve or maintain vitamin D status in healthy populations without the risk of hypercalciuria, but 24 h urinary Ca excretion should be evaluated in healthy persons receiving vitamin D3 supplementation in weekly single doses of 1250 μg (50 000 IU).


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