대한신장학회

논문분류	춘계학술대회 초록집
제목	Vitamin D Deficiency is Significantly associated with Anemia in End Stage Renal Disease Patients
저자	Yung Ly Kim1, Hyunwook Kim2, Young Eun Kwon1, Kyoung Sook Park1,Han Jak Ryu1, Mi Jung Lee1, Hyung Jung Oh1, Jung Tak Park1,Seung Hyeok Han1, Tae-Hyun Yoo1, Kyu Hun Choi1, Shin-Wook Kang1
출판정보	2014; 2014(1):
키워드	비타민 D 결핍, 빈혈, 말기신부전
초록	Background: Anemia of chronic disease (ACD) is the most common form of anemia in chronic kidney disease (CKD) patients. Resistance to erythropoietin and cytokines which shorten red blood cell survival are known to be crucial causes of ACD in these patients. Accumulating evidence suggests that vitamin D can affect the efficacy of erythropoiesis through its anti-inflammatory action. Although both vitamin D deficiency and anemia are prevalent in CKD patients, the association between these two factors remains poorly understood in patients with end-stage renal disease (ESRD). Methods: This study included 106 ESRD patients who were on the scheduled kidney transplantation in Severance Hospital between April 2002 and June 2004. Patients were categorized into three groups by tertiles of 25-hydroxy vitamin D [25(OH)D] levels measured within 2 weeks before transplantation (Group 1, ≥15.50 ng/mL; Group 2, 9.35 to 15.50 ng/mL; Group 3, <9.35 ng/mL). Independent association between vitamin D and hemoglobin (Hb) concentrations was evaluated by multivariate linear regression analysis. Results: The mean age was 40.9±11.1 years, and 75 patients (70.8%) were male. Among the study participants, 49 patients (46.2%) were on hemodialysis, 22 (20.8%) were on peritoneal dialysis, and 35 (33%) were preemptive. Overall, the mean serum 25(OH)D levels were 13±6.31 ng/mL and the mean Hb concentrations were 9.45±1.76 g/ dL. There was a significant trend of a decrease in Hb levels across the tertiles of 25(OH)D concentrations (mean Hb; 9.9±1.7 in Group 1, 9.4±1.7 in Group 2, and 9.0±1.8 g/dL in Group 3, p=0.047). Moreover, Hb levels were positively associated with serum 25(OH)D concentrations (r=0.30, p=0.002). Multivariate linear regression analysis showed that serum 25(OH)D levels were independently associated with Hb concentrations after adjustment for age, serum calcium and phosphorus, intact parathyroid hormone, and the use of erythropoiesis stimulating agents (per 1 ng/mL increase, β=0.08, p=0.03). Conclusions: Vitamin D deficiency is independently associated with anemia in ESRD patients.
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