Background: Vitamin D insufficiency is associated with proteinuria and could be a risk factor for end-stage renal\r\ndisease (ESRD). However, few studies have examined the significance of vitamin D insufficiency as a contributing\r\nfactor for the development of ESRD in the Asian chronic kidney disease (CKD) population.\r\nMethods: Authors examined the relationship between vitamin D status and the staging of CKD using data from an\r\noutpatient clinic-based screening in 2,895 Thai CKD patients. Serum levels of 25-hydroxyvitamin D were analyzed\r\naccording to CKD stages. Vitamin D deficiency and insufficiency were defined as a serum 25-hydroxyvitamin D\r\nconcentration < 10 ng/mL and 10ââ?¬â??30 ng/mL, respectively.\r\nResults: The mean (SD) 25-hydroxyvitamin D levels were significantly lower according to severity of renal\r\nimpairment (CKD stage 3a: 27.84Ã?±14.03 ng/mL, CKD stage 3b: 25.86Ã?±11.14 ng/mL, CKD stage 4: 24.09Ã?±11.65 and\r\nCKD stage 5: 20.82Ã?±9.86 ng/mL, p<0.001). The prevalence of vitamin D deficiency/insufficiency was from CKD stage\r\n3a, 3b, 4 to 5, 66.6%, 70.9%, 74.6%, and 84.7% (p<0.001). The odds ratio (95% CI) of vitamin D insufficiency/\r\ndeficiency (serum 25-hydroxyvitamin D = 30 ng/mL) and vitamin D deficiency (serum 25-hydroxyvitamin D < 10\r\nng/mL) for developing ESRD, after adjustment for age, gender, hemoglobin, serum albumin, calcium, phosphate\r\nand alkaline phosphatase were 2.19 (95% CI 1.07 to 4.48) and 16.76 (95% CI 4.89 to 57.49), respectively.\r\nConclusion: This study demonstrates that 25-hydroxyvitamin D insufficiency and deficiency are more common and\r\nassociated with the level of kidney function in the Thai CKD population especially advanced stage of CKD.
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