Prevalence of calcidiol deficiency in CKD: A cross-sectional study across latitudes in the United States

Robert E. LaClair, Richard N. Hellman, Sharon Karp, Michael Kraus, Susan Ofner, Qian Li, Karen L. Graves, Sharon Moe

Research output: Contribution to journalArticle

283 Citations (Scopus)

Abstract

Background: Recent Kidney Disease Outcomes Quality Initiative guidelines have raised concerns of 25-hydroxyvitamin D, or calcidiol, insufficiency and deficiency in patients with chronic kidney disease (CKD) not yet on dialysis therapy; however, no cross-sectional study across latitudes has been performed to support this assertion. Methods: Baseline screening data from a prospective study were used to determine calcidiol levels in subjects with moderate to severe CKD not yet on dialysis therapy from 12 geographically diverse regions of the United States. Calcidiol deficiency is defined as levels less than 10 ng/mL (<25 nmol/L), and insufficiency, as levels of 10 to 30 ng/mL (25 to 75 nmol/L). Results: Two hundred one subjects with a mean age 65 ± 13 years and calculated glomerular filtration rate (GFR) of 27 ± 11 mL/min (0.45 mL/s) were evaluated. Overall mean calcidiol level was 19.4 ± 13.6 ng/mL (48 ± 34 nmol/L), with a range of 0 to 65 ng/mL (0 to 162 nmol/L). Only 29% and 17% of subjects with moderate and severe CKD had sufficient levels, respectively. Mean calcidiol levels were less than sufficient levels in all geographic locations tested. Multivariate analysis found log calcidiol level correlated with calcium level (P = 0.016), log calcitriol level (P = 0.024), sex (P = 0.041), geographic location (P = 0.045), and inverse intact parathyroid hormone level (P = 0.013), but not calculated GFR or phosphorous level. Calcidiol levels changed modestly in 18 patients who had calcidiol levels measured in winter and late summer after confirmed exposure to sunlight, with mean calcidiol levels of 17.9 ± 11.7 to 21.2 ± 10.0 ng/mL (45 ± 29 to 53 ± 25 nmol/L; P = 0.015). Conclusion: This cross-sectional cohort study found a high prevalence of calcidiol deficiency and insufficiency in patients with moderate and severe CKD not on dialysis therapy regardless of geographic location.

Original languageEnglish
Pages (from-to)1026-1033
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume45
Issue number6
DOIs
StatePublished - Jun 2005

Fingerprint

Calcifediol
Chronic Renal Insufficiency
Cross-Sectional Studies
Geographic Locations
Dialysis
Glomerular Filtration Rate
Calcitriol
Sunlight
Kidney Diseases
Parathyroid Hormone
Cohort Studies
Therapeutics
Multivariate Analysis
Prospective Studies
Guidelines
Calcium

Keywords

  • Calcidiol
  • Chronic kidney disease (CKD)
  • Vitamin D

ASJC Scopus subject areas

  • Nephrology

Cite this

Prevalence of calcidiol deficiency in CKD : A cross-sectional study across latitudes in the United States. / LaClair, Robert E.; Hellman, Richard N.; Karp, Sharon; Kraus, Michael; Ofner, Susan; Li, Qian; Graves, Karen L.; Moe, Sharon.

In: American Journal of Kidney Diseases, Vol. 45, No. 6, 06.2005, p. 1026-1033.

Research output: Contribution to journalArticle

LaClair, Robert E. ; Hellman, Richard N. ; Karp, Sharon ; Kraus, Michael ; Ofner, Susan ; Li, Qian ; Graves, Karen L. ; Moe, Sharon. / Prevalence of calcidiol deficiency in CKD : A cross-sectional study across latitudes in the United States. In: American Journal of Kidney Diseases. 2005 ; Vol. 45, No. 6. pp. 1026-1033.
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abstract = "Background: Recent Kidney Disease Outcomes Quality Initiative guidelines have raised concerns of 25-hydroxyvitamin D, or calcidiol, insufficiency and deficiency in patients with chronic kidney disease (CKD) not yet on dialysis therapy; however, no cross-sectional study across latitudes has been performed to support this assertion. Methods: Baseline screening data from a prospective study were used to determine calcidiol levels in subjects with moderate to severe CKD not yet on dialysis therapy from 12 geographically diverse regions of the United States. Calcidiol deficiency is defined as levels less than 10 ng/mL (<25 nmol/L), and insufficiency, as levels of 10 to 30 ng/mL (25 to 75 nmol/L). Results: Two hundred one subjects with a mean age 65 ± 13 years and calculated glomerular filtration rate (GFR) of 27 ± 11 mL/min (0.45 mL/s) were evaluated. Overall mean calcidiol level was 19.4 ± 13.6 ng/mL (48 ± 34 nmol/L), with a range of 0 to 65 ng/mL (0 to 162 nmol/L). Only 29{\%} and 17{\%} of subjects with moderate and severe CKD had sufficient levels, respectively. Mean calcidiol levels were less than sufficient levels in all geographic locations tested. Multivariate analysis found log calcidiol level correlated with calcium level (P = 0.016), log calcitriol level (P = 0.024), sex (P = 0.041), geographic location (P = 0.045), and inverse intact parathyroid hormone level (P = 0.013), but not calculated GFR or phosphorous level. Calcidiol levels changed modestly in 18 patients who had calcidiol levels measured in winter and late summer after confirmed exposure to sunlight, with mean calcidiol levels of 17.9 ± 11.7 to 21.2 ± 10.0 ng/mL (45 ± 29 to 53 ± 25 nmol/L; P = 0.015). Conclusion: This cross-sectional cohort study found a high prevalence of calcidiol deficiency and insufficiency in patients with moderate and severe CKD not on dialysis therapy regardless of geographic location.",
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T1 - Prevalence of calcidiol deficiency in CKD

T2 - A cross-sectional study across latitudes in the United States

AU - LaClair, Robert E.

AU - Hellman, Richard N.

AU - Karp, Sharon

AU - Kraus, Michael

AU - Ofner, Susan

AU - Li, Qian

AU - Graves, Karen L.

AU - Moe, Sharon

PY - 2005/6

Y1 - 2005/6

N2 - Background: Recent Kidney Disease Outcomes Quality Initiative guidelines have raised concerns of 25-hydroxyvitamin D, or calcidiol, insufficiency and deficiency in patients with chronic kidney disease (CKD) not yet on dialysis therapy; however, no cross-sectional study across latitudes has been performed to support this assertion. Methods: Baseline screening data from a prospective study were used to determine calcidiol levels in subjects with moderate to severe CKD not yet on dialysis therapy from 12 geographically diverse regions of the United States. Calcidiol deficiency is defined as levels less than 10 ng/mL (<25 nmol/L), and insufficiency, as levels of 10 to 30 ng/mL (25 to 75 nmol/L). Results: Two hundred one subjects with a mean age 65 ± 13 years and calculated glomerular filtration rate (GFR) of 27 ± 11 mL/min (0.45 mL/s) were evaluated. Overall mean calcidiol level was 19.4 ± 13.6 ng/mL (48 ± 34 nmol/L), with a range of 0 to 65 ng/mL (0 to 162 nmol/L). Only 29% and 17% of subjects with moderate and severe CKD had sufficient levels, respectively. Mean calcidiol levels were less than sufficient levels in all geographic locations tested. Multivariate analysis found log calcidiol level correlated with calcium level (P = 0.016), log calcitriol level (P = 0.024), sex (P = 0.041), geographic location (P = 0.045), and inverse intact parathyroid hormone level (P = 0.013), but not calculated GFR or phosphorous level. Calcidiol levels changed modestly in 18 patients who had calcidiol levels measured in winter and late summer after confirmed exposure to sunlight, with mean calcidiol levels of 17.9 ± 11.7 to 21.2 ± 10.0 ng/mL (45 ± 29 to 53 ± 25 nmol/L; P = 0.015). Conclusion: This cross-sectional cohort study found a high prevalence of calcidiol deficiency and insufficiency in patients with moderate and severe CKD not on dialysis therapy regardless of geographic location.

AB - Background: Recent Kidney Disease Outcomes Quality Initiative guidelines have raised concerns of 25-hydroxyvitamin D, or calcidiol, insufficiency and deficiency in patients with chronic kidney disease (CKD) not yet on dialysis therapy; however, no cross-sectional study across latitudes has been performed to support this assertion. Methods: Baseline screening data from a prospective study were used to determine calcidiol levels in subjects with moderate to severe CKD not yet on dialysis therapy from 12 geographically diverse regions of the United States. Calcidiol deficiency is defined as levels less than 10 ng/mL (<25 nmol/L), and insufficiency, as levels of 10 to 30 ng/mL (25 to 75 nmol/L). Results: Two hundred one subjects with a mean age 65 ± 13 years and calculated glomerular filtration rate (GFR) of 27 ± 11 mL/min (0.45 mL/s) were evaluated. Overall mean calcidiol level was 19.4 ± 13.6 ng/mL (48 ± 34 nmol/L), with a range of 0 to 65 ng/mL (0 to 162 nmol/L). Only 29% and 17% of subjects with moderate and severe CKD had sufficient levels, respectively. Mean calcidiol levels were less than sufficient levels in all geographic locations tested. Multivariate analysis found log calcidiol level correlated with calcium level (P = 0.016), log calcitriol level (P = 0.024), sex (P = 0.041), geographic location (P = 0.045), and inverse intact parathyroid hormone level (P = 0.013), but not calculated GFR or phosphorous level. Calcidiol levels changed modestly in 18 patients who had calcidiol levels measured in winter and late summer after confirmed exposure to sunlight, with mean calcidiol levels of 17.9 ± 11.7 to 21.2 ± 10.0 ng/mL (45 ± 29 to 53 ± 25 nmol/L; P = 0.015). Conclusion: This cross-sectional cohort study found a high prevalence of calcidiol deficiency and insufficiency in patients with moderate and severe CKD not on dialysis therapy regardless of geographic location.

KW - Calcidiol

KW - Chronic kidney disease (CKD)

KW - Vitamin D

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