|
Essential Oils |
Bella Mira Essential Oil Supplements
Essential Oil Information and Use
|
Chemical Free |
Chemical Free Body Care Products
|
Gluten Free |
Gluten Free Living and Recipes
|
Important Information |
Detoxification and Digestion Products
Save Your Computer Free Protection
|
Great Products |
|
FREE Wellness Tests |
Hormone Balance Test New Improved
|
Contact Us |
Our Shopping Cart Is:
Free Samples w/$150 Order (when available)
Vitamin D Deficiency Linked to Anemia in Chronic Kidney Disease 10-10-08
In patients with chronic kidney disease, vitamin D deficiency may increase
the risk of anemia, a cross-sectional study showed.
Patients with the lowest levels of calcidiol -- 25-hydroxyvitamin D -- were 2.8
times more likely to have anemia (95% CI 1.5 to 5.1) than those with the highest
levels, Orlando Gutierrez, M.D., of the University of Miami in Florida, reported
at the American Society of Nephrology meeting here.
Patients who had the lowest levels of calcitriol -- 1,25-dihydroxyvitamin D --
had a similarly increased risk (OR 2.0, 95% CI 1.5 to 2.9).
"The possibility that vitamin D receptor activation may be useful in the direct
or indirect treatment of anemia is intriguing and needs to be further explored,"
Dr. Gutierrez said.
Although vitamin D deficiency and anemia are both common in chronic kidney
disease, few studies have examined the relationship between the two, according
to Dr. Gutierrez.
He said that past studies have shown that calcitriol increases erythropoietin
receptor expression in hematopoietic progenitor cells and works together with
erythropoietin to increase the cells' proliferation.
Thus, he and his colleagues hypothesized that vitamin D deficiency may be
associated with anemia in chronic kidney disease.
To test that hypothesis, they examined levels of hemoglobin, calcidiol, and
calcitriol in 1,661 participants 40 and older (mean 70) in the Study to Evaluate
Early Kidney Disease (SEEK), which was conducted at 153 U.S. centers. All
patients had untreated, early chronic kidney disease.
Patients were excluded if they required renal replacement therapy, had primary
parathyroid disease, or were using prescription vitamin D therapy.
Participants' mean estimated glomerular filtration rate was 47 mL/min/1.73 m2
and mean hemoglobin was 13.0 g/dL.
Overall, 41% of the patients were anemic, defined as a hemoglobin of less than
13.5 g/dL for men and less than 12.0 g/dL for women.
Anemic patients were slightly older and more likely to be male, black, and to
have diabetes, hypertension, a lower estimated glomerular filtration rate, lower
concentrations of both vitamin D types, and a higher parathyroid hormone
concentration (P<0.01 for all).
Just over half of the patients (54.8%) had a calcidiol concentration of 10 to 30
ng/mL; 3% had a lower concentration and 42% had a higher concentration.
After adjusting for age, sex, race, estimated glomerular filtration rate,
diabetes, and parathyroid hormone, mean hemoglobin levels dropped from 13.5 g/dL
in patients with the highest levels of calcidiol to 11.7 g/dL in those with the
lowest levels (P<0.001 for trend).
Almost 70% of those in the lowest tertile and about 47% in the middle tertile
had anemia, compared with 31% in the highest tertile (P<0.01 for both
comparisons).
For calcitriol concentration, 54% of patients had a level less than 30 pg/mL;
27% had a concentration of 30 to 45 pg/mL and 19% had a concentration greater
than 45 pg/mL.
Mean hemoglobin levels dropped from 13.7 g/dL in patients with the highest
levels of calcitriol to 12.7 g/dL in those with the lowest levels (P<0.001 for
trend).
About 50% in the lowest tertile and 30% in the middle tertile had anemia,
compared with 24% in the highest tertile (P<0.01 for both comparisons).
Adjusting for markers of inflammation did not affect the results.
"We conclude that deficiencies of both [calcitriol and calcidiol] are
independently associated with anemia in patients with chronic kidney disease,"
Dr. Gutierrez said.
He acknowledged some limitations of the study, including the inability to
establish causality because of the cross-sectional design, the lack of data on
the use of erythropoiesis-stimulating agents, and the lack of information on
erythropoietin concentrations and iron stores, which may be important
confounders.
Search Vitamin D:
Search Kidney:
