1,25 dihydroxy vitamin D and 25 hydroxyl vitamin D in chronic kidney disease patients and their values for minotring the disease status
Objective To study the shifts of 1,25 dihydroxyvitamin D and 25 hydroxyl vitamin D in the blood of patients with chronic kidney disease and their relationships with other biochemical parameters of kidney,liver and bone;exploring the two kinds of vitamin D assay on the monitoring value in chronic kidney disease patiens.Methods The subjects included 48 patients with clini-cally confirmed CKD(study group)and 50 patients with other diseases or healthy persons(control group),1,25(OH)2D,25(OH)D,parathyroid hormone,calcium,phosphorus,alkaline phosphatase,creatinine,urea nitrogen,uric acid,albumin,total protein,AST,ALT and total bilirubin were detected for both groups;and t-test,multi-factor logistic regression and correlation cluster analysis were performed for the results of various biochemical parameters.Results 1,25(OH)2D was significantly lower in the study group than the control group[(8.55±6.75)vs(46.42±23.05 pmol/L,P＜0.001],meanwhile 25(OH)D was only slightly low[(13.55±5.85)vs(17.61±6.30)ng/mL,P=0.002].The correlation between 1,25(OH)2D and 25(OH)D was very low(R=0.16,P＞0.05);The serum levels of 1,25(OH)2 D and 25(OH)D in the study group were significantly lower than those in the age group be-low 59 years old,and the serum levels of 1,25(OH)2D and 25(OH)D in the age group above 60 years old and under 59 years old were significantly lower than those in the control group.After adjusting for sex and age by multivariate logistic regression,1,25(OH)2 D was significant in distinguishing the study group from the control group(OR=0.007,P＜0.001),while 25(OH)D was not significant(OR=0.027,P=0.068).iPTH,phosphorus,ALP,creatinine and urea nitrogen were significantly higher in the study group(P＜0.01),while 1,25(OH)2 D,calcium,total bilirubin,albumin and total protein were significantly lower in the study group(P＜0.01);hierarchical cluster analysis shows the close level with renal function(eGFR)were in order creatinine,urea nitrogen,serum protein,calcium,1,25(OH)2D,phosphorus,iPTH,total bilirubin,ALP;and 25(OH)D was far away from any biochemical parameters.Conclusion Serum levels of 1,25(OH)2D and 25(OH)D are significantly decreased in the elderly over 60 years old,whether normal or with CKD.The elderly with CKD are more prone to vitamin D deficiency.1,25(OH)2D assay is difficult and com-plicated,currently only manual technology is available,while 25(OH)D is widely used in clinical practice.However,1,25(OH)2D was more significant in patients and more closely related to the biochemistry of kidney,bone and liver,therefore it may have greater value in monitoring the disease status of CKD.
万方数据
