DETERMINATION OF VITAMIN-D, CRP & ASSOCIATION WITH HEMOGLOBIN LEVEL IN HEMODIALYSIS PATIENTS
Main Article Content
Keywords
Chronic kidney disease (CKD), Glomerular filtration rate (GFR), C-reactive protein (CRP)
Abstract
Background: Chronic kidney disease (CKD) is becoming a major chronic illness in the world. In India, population >1 billion people facing renal disorders, the rising incidence of CKD is expected to pose major challenges to both the healthcare system and the economy in the coming years. The number of patients with chronic kidney disease (CKD) has been rising, impacting an estimated 843.6 million people globally in 2017. This increase can be partially attributed to the rise in risk factors, such as obesity, hypertension, and diabetes mellitus. Several human and animal studies have suggested that vitamin D deficiency may be a contributory factor in the pathogenesis of chronic kidney disease. The primary causes of anemia in CKD include low erythropoietin levels from loss of erythropoietin synthesis or from presence of inhibitors of erythropoietin production, iron deficiency, and decreased half-life of circulating red blood cells. CRP is also a major acute phase reactant which is elevated as a response to tissue damage and is considered as an important indicator of systemic inflammation
Materials and Methods: The total study group consists of 200 subjects, of which 100 Hemodialysis patients (cases) & 100 were healthy individuals (controls). Venous blood was used for analysis. Renal function test were done on Erba EM 200 chemistry analyzer, Serum electrolytes by Ion selective electrode on PSR ST 200, Serum VIT-D by Competitive Fluorescent Immunoassay & Serum CRP by Turbidimetric method. The data analysis was done by using mean, standard deviation & student t-test.
Results: Vit-D (10.79 ± 2.03 vs. 38.81 ± 5.90), Hb (7.13 ± 0.70 vs. 13.35 ± 0.87) were lower in Hemodialysis patients than control subjects. The Crp (90.92 ± 34.9 vs. 2.21 ± 1.23) was higher in Hemodialysis patients than control subjects. The level of serum Vit-D & Hb were significantly decreased in Hemodialysis patients as compared to healthy individuals.
Conclusion: The present study concluded that decrease activity of vitamin D, calcium, Hemoglobin & significant elevation of CRP, phosphorus & potassium in Hemodialysis patients as compared to healthy individuals.
References
2. Jager KJ, Kovesdy C, Langham R, et al. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Kidney Int. 2019; 96:1048-50.
3. Modi GK, Jha V. The incidence of end-stage renal disease in India: a population-based study. Kidney Int. 2006; 70(12):2131-33.
4. Kher V. End-stage renal disease in developing countries. Kidney Int. 2002; 62(1):350-62.
5. RE Weishaar, SN Kim, D E Saunders, R U Simpson. Involvement of vitamin D3 with cardiovascular function. III. Effects on physical and morphological properties. American Journal of Physiology-Endocrinology and Metabolism.1990; 258(1): 134–142.
6. I Loftus, M Thompson. Role of matrix metalloproteinase in vascular disease. Vascular Medicine. 2016; 7(2): 117–133.
7. Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357:266-81.
8. Wang CJ, McCauley LK. Osteoporosis and periodontitis. Curr Osteoporosis Rep. 2016; 14:284-91.
9. UrenaTorres P, Metzger M, Haymann JP et al. Association of kidney function, vitamin D deficiency, and circulating markers of mineral and bone disorders in CKD. American J Kidney Dis. 2011; 58:544-53.
10. McGonigle RJ, Wallin JD, Shadduck RK, Fisher JW. Erythropoietin deficiency and inhibition of erythropoiesis in renal insufficiency. Kidney International. 1984;25:437–444
11. Radtke HW, Claussner A, Erbes PM, Scheuermann EH, Schoeppe W, Koch KM. Serum erythropoietin concentration in chronic renal failure: relationship to degree of anemia and excretory renal function. Blood. 1979; 54: 877–884.
12. Erslev AJ, Besarab A. The rate and control of baseline red cell production in hematologically stable patients with uremia. J Lab Clin Med. 1995;126:283-286.
13. YaoQ, Lindholm B, Stenvinkel P. Inflammation as a Cause of Malnutrition, Atherosclerotic Cardiovascular Disease, and Poor Outcome in Hemodialysis Patients. Hemodial Int. 2004; 8:118-29.
14. Pearson, TA et al. AHA/CDC Scientific Statement: Markers of Inflammation and Cardiovascular Disease-Application to Clinical and Public Health Practice. Circulation.2003; 107:499- 511.
15. Wachtel M. et al, Creation and Verification of Reference Intervals. Laboratory Medicine 1995; 26: 593-97.
16. Kroll MH, Elin RJ. Clin Chem, 1983 : 29 : 2044
17. Searcy, RL .Diagnostic Biochemistry. Mc Graw-Hill, New York, 1969.
18. Fogh Anderson et al. Determination of sodium & potassium with ion selective electrodes. Clin Chem. 1984; 30(3): 433-36.
19. Holick MF. Vitamin D deficiency .The New England journal of medicine 2007; 357 (3): 266-81.
20. Chetana Vaishnavi. Immunology & infectious disease 1996; 6:139-144.
21. Theodosios kantas et al. Relationship between Chronic Kidney Disease Staging and Vitamin D Deficiency: A Retrospective Study. Cureus 2022; 14(1): 1-8.
22. Kendrick J, Targher G ,Smits G Chonchol M. 25-Hydroxyvitamin D Deficiency and Inflammation and Their Association with Hemoglobin Levels in Chronic Kidney Disease. Am J Nephrol 2009;30:64-72
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Brahma Reddy Malapati
Associate professor, Department of Biochemistry MK Shah Medical College, Ahmadabad Gujarat, India
Murali Manohar Shah
Assistant professor, Department of Biochemistry Rama Medical College & Hospital, Hapur
Shikha Agarwal
Associate professor, Department of Biochemistry Rama Medical College & Hospital, Hapur
Anuradha pal
Tutor, Department of Biochemistry Rama Medical College & Hospital, Hapur
Poonam Agarwal
Professor & Head, Department of Biochemistry Rama Medical College & Hospital, Hapur
Payal Sharma
Tutor, Department of Biochemistry Rama Medical College & Hospital, Hapur
Anil kumar Jhajharia
Consultant Nephrologist, Rama Medical College & Hospital, Hapur
Mritunjay Kumar Mishra
Assistant Professor, Department of Biochemistry, GMERS Medical College, Rajpipla, Gujarat, India