SAT-LB091 Vitamin D Status in Doing-Well Medical Ambulatory Patients with Mild to Moderate Kidney Impairment

Abstract

Several studies have shown high prevalence of low serum 25-hydroxyvitamin D (25OHD) level in severe chronic kidney disease (CKD). However, studies on vitamin D status in patients with mild to moderate kidney impairment such as stages 1 to 3b CKD are limited. This cross-sectional study aimed to examine vitamin D status in doing-well ambulatory patients with stable medical conditions who had mild to moderate kidney impairment defined by estimated glomerular filtration rate (eGFR) of >30 mL/min/1.73m2. All patients had no conditions known to affect vitamin D status including vitamin D supplementation and were assessed for renal function, 25OHD, and parathyroid hormone (PTH) levels. Data are expressed as mean ± SD (range) or % as appropriate. There were 333 patients with a mean age of 64.5 ± 10.3 years old (26 - 88), 67.9% were elderly (aged >60), and 63.7% were female. The patients’ major underlying diseases included type 2 diabetes mellitus (71.5%), hypertension (69.1%), dyslipidemia (82.8%), and coronary artery disease (6.9%). Mean serum 25OHD was 25.1 ± 10.1 ng/mL (3.0 - 70.0). 42.1%, 29.7% and 2.7 % of the patients had 25OHD of 20 - <30, 10 - <20, and <10 ng/mL, respectively. Mean eGFR was 71.7 ± 20.3 mL/min/1.73m2 (30.8 - 119.8). 22.9%, 48.2%, 19.8%, and 9.0% of the patients had stages 1, 2, 3a and 3b CKD (defined by eGFR ≥90, 60 - <90, 45 - <60, and 30 - <45 mL/min/1.73m2, respectively). In the elderly patients (age >60), the prevalence of 25OHD of 20 - <30, 10 - <20, and <10 ng/mL were 44.2%, 23.0%, and 2.7%, respectively. At eGFR cut-off value of ≥60 mL/min/1.73 m2, the elderly patients with lower eGFR had higher prevalence of 25OHD of <20 ng/mL and 25OHD of <10 ng/mL than their counterparts (33.7% vs. 20.1% and 5.4% vs. 0.7%, respectively, both p <0.05). At lower eGFR cut-off value of ≥45 mL/min/1.73 m2, those with lower eGFR had higher prevalence of 25OHD of <10 ng/mL and higher serum PTH levels than their counterparts (11.1% vs. 1.5%, and 58.5 ± 25.5 vs. 49.3 ± 21.7 pg/mL, respectively, both p <0.05). In non-elderly patients (age ≤60), the prevalence of 25OHD of 20 - <30, 10 - <20, and <10 ng/mL were 37.4%, 43.9%, and 2.8%, respectively. No significant differences in vitamin D status between non-elderly patients with higher and lower eGFR either at eGFR cut-off values of ≥60 or ≥45 mL/min/1.73m2 were observed. In conclusions, prevalence of insufficient vitamin D status was high in patients with mild to moderate kidney impairment. Elderly doing-well medical ambulatory patients with moderate kidney impairment had higher prevalence of vitamin D deficiency (25OHD <20 ng/mL) and severe vitamin D deficiency (25OHD <10 ng/mL) than those with mild kidney impairment. Surveillance for insufficient vitamin D status and vitamin D supplementation are recommended in these patients. However, the relationship between level of kidney function and vitamin D status was not observed in non-elderly patients with mild to moderate kidney impairment. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.