关键词: 25羟基-维生素D , 冠心病, RAAS阻断剂, 相关性

Abstract:

Objectives: Vitamin D deficiency has been reported to be closely associated with many clinical complications such as cardiovascular events and osteodystrophy in chronic renal failure patients. The aims of this study are to screen serum Vitamin D level in maintenance hemodialysis (MHD) patients from our hemodialysis center and analyze their clinical features. Methodology: Two hundred and seventy eight MHD patients were enrolled in this study, and their serum 25-hydroxyvitamin-D level was detected by using a commercial available ELISA kit. The correlation of patients’ clinical features including age, gender, body mass index (BMI), blood pressure, medicine, primary kidney disease, duration of dialysis, complications and biochemical indexes with their serum 25(OH)D level were analyzed by using multiple logic regression analysis method. Results: They were 175 male and 113 female with an average  of 57.4 ±18.2 years old (ranged from 23 to 89) and the duration dialysis of 62.3 ±61.9 months. Serum 25(OH)D deficiency (<15ng/ml) and insufficiency (15~30ng/ml) were present in 55% and 37% of the dialysis patients respectively. Only 8% of the patients showed normal serum 25(OH)D level. Further analysis of their clinical features revealed that Vitamin D deficiency was more prevalent in female or patients with cardiovascular complications (P<0.05), while less Vitamin D deficiency could be found in male or patients received RAAS inhibitors (P<0.05). Diabetic patients showed a low 25(OH)D level compared with the other patients. No close correlation was found as to the other clinical features including age, BMI, serum calcium and iPTH levels with Vitamin D deficiency. Conclusion: The prevalence of hypovitaminosis D is high in MHD patients. The female, cardiovascular complications and diabetes are correlated with Vitamin D deficiency, and taking RAAS inhibitors may benefit the patients with such deficiency.