Study of vitamin B12 deficiency in chronic kidney disease

Abstract

Background: Chronic Kidney Disease (CKD) is a growing health burden and important cause of morality and morbidity worldwide as well as India. Anaemia a feature of CKD, is multifactorial, one of the most important factor responsible for the development of left ventricular hypertrophy, diastolic and later systolic dysfunction and cardiovascular disease, which is the single most important contributor to the mortality in CKD. Severe Chronic Kidney Disease has an adverse effect on haematopoiesisis. Lack of erythropoietin, Iron deficiency anaemia and shortened red cell life span, Nutritional deficiency or deranged metabolism of vitamins is the major factors contributing to anaemia in CRF. Patients with CKD show megaloblastosis on examination of the bone marrow. Suggestive of Vitamin B12 and folic acid deficiency might Be Additional Factors Contributing to inadequate Haematopoiesis in uremia. Patients with CKD are at higher risk for nutritional deficiencies due to medication interactions, dietary restrictions and malnutrition. The dialysis procedure itself may cause loss of vitamin B12, Folic acid and there deficiency.Methods: Sample size of 80 cases of CKD patients aged between 18-80 year admitted in SMIMER Hospital were included in study. Serum vitamin B12 Level was checked, correlation B12 deficiency with duration of CKD was observed.Results: It was observed that, 47 cases of CKD had vitamin B12 deficiency. The mean duration of CKD is more in B12deficient group as compared to Normal Group and also finds the higher proportion of vitamin B12 deficiency in CKD patients.Conclusions: Serum vitamin B12 level testing should be recommended routinely in patients with CKD and All the treating Nephrologists should anticipate the deficiency of vitamin B12 in CKD patients.