Severe vitamin D deficiency upon admission in critically ill patients is related to acute kidney injury and a poor prognosis

Abstract

ObjectivesTo evaluate the prevalence of vitamin D deficiency in critically ill patients upon admission to an Intensive Care Unit (ICU) and its prognostic implications. DesignA single-center, prospective observational study was carried out from January to November 2015. Patients were followed-up on until death or hospital discharge. SettingThe department of Critical Care Medicine of a university hospital. PatientsAll adults admitted to the ICU during the study period, without known factors capable of altering serum 25(OH)D concentration. InterventionsDetermination of serum 25(OH)D levels within the first 24h following admission to the ICU. Main variables of interestPrevalence and mortality at 28 days. ResultsThe study included 135 patients, of which 74% presented deficient serum 25(OH)D levels upon admission to the ICU. Non-survivors showed significantly lower levels than survivors (8.14ng/ml [6.17–11.53] vs. 12ng/ml [7.1–20.30]; p=.04), and the serum 25(OH)D levels were independently associated to mortality (OR 2.86; 95% CI 1.05–7.86; p=.04). The area under the ROC curve was 0.61 (95% CI 0.51–0.75), and the best cut-off point for predicting mortality was 10.9ng/ml. Patients with serum 25(OH)D<10.9ng/ml also showed higher acute kidney injury rates (13 vs. 29%; p=.02). ConclusionVitamin D deficiency is highly prevalent upon admission to the ICU. Severe Vitamin D deficiency (25[OH]D<10.9ng/ml) upon admission to the ICU is associated to acute kidney injury and mortality.