CHRONIC KIDNEY DISEASE (CKD)

Vitamin D deficiency is pretty common among the patients withCKD some studies suggesting it to be starting from CKD 3 when the egfr start falling from60 ml/min. The cause can be due to different reasons including race, obesity, nutrition, lackof exposure to sun, and not the least, decrease in 1,alpha hydroxylase once the gfr starts tofall significantly. Objectives: The hypothesis was that lower Vitamin D level will be associatedwith increased inflammatory burden and decreased immunological response. Study Design:This was a cross-sectional study looking at the relationship between Vitamin D level andinflammatory markers in CKD 4 Pts when egfr started falling from 30 ml/min. Study Design andDuration: The study was started in March 2016 and finished in May 2016 among consecutive100 CKD 4 patients coming to the clinic who were identified to be eligible for the study. Materialsand Methods: We looked at the relationship between Vitamin D level and markers of mineralbone disorder, similarly we also looked at the relationship between erythropoietin dosage,hemoglobin and Vitamin D levels. Erythropoietin dose, hemoglobin, transferrin saturation,were used to study the link between Vitamin D and markers of anemia. Hepatitis B surfaceantigen antibodies were measured to study the response between Vitamin D level and immuneresponse to Hep B vaccine. Results: Vitamin D levels were significantly lower in diabeticscompared to non-diabetics (P = 0.02) and lower in females compared to males (P = 0.009).No statistical significance was observed between Vitamin D levels and immune response tohepatitis B vaccine (P = 0.89), phosphate level (P= 0.1), calcium levels (P = 0.79), parathyroidhormone (PTH) levels (P = 0.57), C-reactive protein (P =0.19), serum albumin (P = 0.17),hemoglobin level (P = 0.18,) and erythropoietin requirement (P = 0.87).Conclusions VitaminD deficiency is highly prevalent in advanced CKD in Saudi Arabia. A RCT is recommendedregarding response to vitamin D supplementation.