Loss Via Peritoneal Fluid As a Factor for Low 25(OH)D3 Level in Peritoneal Dialysis Patients

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2009 May 1

PMID 19404765

Citations 7

Authors

Garip Sahin

Ismail Kirli

Basar Sirmagul

Ertugrul Colak

Ahmet Ugur Yalcin

Affiliations

Soon will be listed here.

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.

Citing Articles

A feasibility study of avoiding positive calcium balance and parathyroid hormone increase in patients on peritoneal dialysis.

Piraciaba M, Cordeiro L, Guimaraes E, Abensur H, Pereira B, Jorgetti V Bone Rep. 2022; 17:101625.

PMID: 36217349 PMC: 9547188. DOI: 10.1016/j.bonr.2022.101625.

Cholecalciferol supplementation increases FGF23 in peritoneal dialysis patients with hypovitaminosis D: a randomized clinical trial.

Ramirez-Sandoval J, Arvizu-Hernandez M, Cruz C, Vazquez-Cantu B, Rojas-Concha L, Tamez L J Nephrol. 2019; 32(4):645-659.

PMID: 30888584 DOI: 10.1007/s40620-019-00599-x.

Clinical management of patients on peritoneal dialysis in Italy: results from the ATENA study.

Crepaldi C, Possidoni A, Caputo F, DellAquila R, Galli E, Costanzo A Clin Kidney J. 2018; 11(2):275-282.

PMID: 29644071 PMC: 5887992. DOI: 10.1093/ckj/sfx092.

Effects of vitamin D on parathyroid hormone and clinical outcomes in peritoneal dialysis: a narrative review.

Russo R, Ruospo M, Cozzolino M, De Nicola L, Icardi A, Paoletti E J Nephrol. 2014; 27(5):483-94.

PMID: 25012237 DOI: 10.1007/s40620-014-0120-x.

The impact of pretransplant 25-hydroxy vitamin D deficiency on subsequent graft function: an observational study.

Kim H, Kang S, Yoo T, Kim M, Kim S, Kim Y BMC Nephrol. 2012; 13:22.

PMID: 22533967 PMC: 3393620. DOI: 10.1186/1471-2369-13-22.

References

Lips P . Vitamin D physiology. Prog Biophys Mol Biol. 2006; 92(1):4-8. DOI: 10.1016/j.pbiomolbio.2006.02.016. View

Gonzalez E, Sachdeva A, Oliver D, Martin K . Vitamin D insufficiency and deficiency in chronic kidney disease. A single center observational study. Am J Nephrol. 2004; 24(5):503-10. DOI: 10.1159/000081023. View

Cassidy M, Owen J, ELLIS H, Dewar J, Robinson C, Wilkinson R . Renal osteodystrophy and metastatic calcification in long-term continuous ambulatory peritoneal dialysis. Q J Med. 1985; 54(213):29-48. View

Gelev S, Spasovski G, Dzikova S, Trajkovski Z, Damjanovski G, Amitov V . Vascular calcification and atherosclerosis in hemodialysis patients: what can we learn from the routine clinical practice?. Int Urol Nephrol. 2008; 40(3):763-70. DOI: 10.1007/s11255-008-9379-y. View

KOENIG K, Lindberg J, Zerwekh J, Padalino P, Cushner H, Copley J . Free and total 1,25-dihydroxyvitamin D levels in subjects with renal disease. Kidney Int. 1992; 41(1):161-5. DOI: 10.1038/ki.1992.22. View

Saha H . Calcium and vitamin D homeostasis in patients with heavy proteinuria. Clin Nephrol. 1994; 41(5):290-6. View

Thomas M, Lloyd-Jones D, Thadhani R, Shaw A, Deraska D, Kitch B . Hypovitaminosis D in medical inpatients. N Engl J Med. 1998; 338(12):777-83. DOI: 10.1056/NEJM199803193381201. View

Gokal R, Ramos J, ELLIS H, Parkinson I, Sweetman V, Dewar J . Histological renal osteodystrophy, and 25 hydroxycholecalciferol and aluminum levels in patients on continuous ambulatory peritoneal dialysis. Kidney Int. 1983; 23(1):15-21. DOI: 10.1038/ki.1983.4. View

Shah N, Bernardini J, Piraino B . Prevalence and correction of 25(OH) vitamin D deficiency in peritoneal dialysis patients. Perit Dial Int. 2005; 25(4):362-6. View

10.

Aloni Y, Shany S, Chaimovitz C . 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. 1983; 9(2):82-6. View

11.

Holick M . Vitamin D and the kidney. Kidney Int. 1987; 32(6):912-29. DOI: 10.1038/ki.1987.295. View

12.

Ghazali A, Fardellone P, Pruna A, Atik A, Achard J, Oprisiu R . Is low plasma 25-(OH)vitamin D a major risk factor for hyperparathyroidism and Looser's zones independent of calcitriol?. Kidney Int. 1999; 55(6):2169-77. DOI: 10.1046/j.1523-1755.1999.00480.x. View

13.

Taskapan H, Ersoy F, Passadakis P, Tam P, Memmos D, Katopodis K . Severe vitamin D deficiency in chronic renal failure patients on peritoneal dialysis. Clin Nephrol. 2006; 66(4):247-55. DOI: 10.5414/cnp66247. View

14.

Zucchelli P, Catizone L, Casanova S, Fusaroli M, Fabbri L, Ferrari G . Renal osteodystrophy in CAPD patients. Miner Electrolyte Metab. 1984; 10(5):326-32. View

15.

Taskapan H, Wei M, Oreopoulos D . 25(OH) vitamin D3 in patients with chronic kidney disease and those on dialysis: rediscovering its importance. Int Urol Nephrol. 2006; 38(2):323-9. DOI: 10.1007/s11255-006-0081-7. View

16.

Eastwood J, Stamp T, Harris E, DE WARDENER H . Vitamin-D deficiency in the osteomalacia of chronic renal failure. Lancet. 1976; 2(7997):1209-11. DOI: 10.1016/s0140-6736(76)91140-5. View

17.

Spasovski G . Bone health and vascular calcification relationships in chronic kidney disease. Int Urol Nephrol. 2007; 39(4):1209-16. DOI: 10.1007/s11255-007-9276-9. View

18.

. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003; 42(4 Suppl 3):S1-201. View

19.

Hypponen E, Turner S, Cumberland P, Power C, Gibb I . Serum 25-hydroxyvitamin D measurement in a large population survey with statistical harmonization of assay variation to an international standard. J Clin Endocrinol Metab. 2007; 92(12):4615-22. DOI: 10.1210/jc.2007-1279. View

20.

Mucsi I, Almasi C, Deak G, Marton A, Ambrus C, Berta K . Serum 25(OH)-vitamin D levels and bone metabolism in patients on maintenance hemodialysis. Clin Nephrol. 2005; 64(4):288-94. DOI: 10.5414/cnp64288. View