FACTORS AFFECTING NUTRITIONAL VITAMIN D LEVEL IN PATIENTS ON MAINTENANCE HEMODIALYSIS

Abstract

Objective: To determine which factors are affecting nutritional vitamin D levels in patients on maintenance hemodialysis.
 Study design: Cross sectional descriptive study conducted at DHQ hospital, Sheikhupura.
 Methods: All patients on maintenance hemodialysis for more than one month were included in this study. Patients with acute kidney injury and less than one month on hemodialysis were excluded from the study. Performa was designed for demographic (age, gender, education and address) and laboratory data (hemoglobin, urea, creatinine, albumin, bicarbonate, calcium, phosphate, intact parathyroid-PTH, vitamin D) of all the patients.
 Results: One hundred and forty-six patients were enrolled in the study. Eighty six (58.9%) were from more than fifty-years of age. Fifty eight (39.7%) reported diabetes mellitus and Hypertension was the cause of End Stage Renal Disease (ESRD). All patients were on twice weekly dialysis. One hundred and ninety (81.5%) were started via double lumen catheter, sixty nine (47.3%) had more than hundred total number of dialysis, one hundred and seven (73.3%) had need of transfusion. There was significant association observed of vitamin D3 levels with age, total number of dialysis and blood transfusions required. Vitamin D3 had significantly associated with intact parathyroid (iPTH) levels and albumin, 55.8% sample found with less than ten vitamin D3 level and iPTH between 100-600, whereas 88.4% sample found with less than four albumin levels (p-value < 0.05). 
 Conclusions: Vitamin D levels can be used as nutritional tool in dialysis patients. Age, albumin, PTH, total number of dialysis and blood transfusion had significant association with vitamin D level.