Exploring the interplay between kidney health, vitamin D levels, and mineral/bone disorders in chronic kidney disease (CKD)

Abstract

Introduction: CKD is associated with a number of problems of mineral and bone metabolism, including vitamin D deficiency and secondary hyperparathyroidism. The relationships between a lack of vitamin D, circulating indicators of mineral and bone diseases (MBD), and renal function in CKD are not well understood. This cross-sectional research included 1,060 individuals with CKD stages 2 to 5 from the Institute of Kidney Disease (IKD), Peshawar. In addition to other indicators of bone metabolism, we evaluated the estimated glomerular filtration rate (eGFR), blood levels of Calcifediol, calcium, phosphate, and intact parathyroid hormone (PTH). The results of interest were blood calcium, phosphate, and PTH levels as well as other indicators of bone metabolism. These markers also included circulating markers of MBD. Results: Higher blood Parathyroid Hormones levels, in addition to lower levels of blood calcium and phosphate, were all associated with vitamin D deficiency and decreased eGFR. Additionally, vitamin D deficiency has been independently linked to lower levels of other bone metabolism indicators, including tartrate-resistant acid phosphatase-5b and bone-specific alkaline phosphatase. In patients with CKD, abnormalities in mineral and bone metabolism, including greater PTH levels and lower calcium and phosphate levels, are independently correlated with reduced eGFR and vitamin D insufficiency.