Status of vitamin D, lipid profile and carotid artery intima media thickness in patients with chronic kidney disease stage III to V

Authors

  • Kamal Lochan Behera Department of General Medicine, Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh, India
  • BH. V. K. Praveen Varma Department of General Medicine, Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh, India
  • D. S. S. K. Raju Department of Biochemistry, Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh, India
  • Suresh Babu Sayana Department of Pharmacology, Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20192515

Keywords:

Carotid intima media thickness, Chronic kidney disease, Vitamin D

Abstract

Background: Chronic Kidney Disease (CKD) is characterized by irreversible sclerosis and loss of nephrons. The renal mass progressively declines over a prolonged period, depending on the underlying etiology. In CKD the most common feature is hypovitaminosis D which alter the vascular smooth muscle cell proliferation and reprogram the osteoblastic changes, finally leading to increase arterial wall thickness.

Methods: A cross sectional study carried out over a 2-year period in Department Nephrology and General Medicine OPD, MIMS, Vizianagaram, Andhra Pradesh, India. 120 in which 60 are normal healthy individuals and 60 are CKD patients with stage 3 to 5. In all the participants serum creatinine, blood urea, serum triglycerides serum total cholesterol, HDL cholesterol estimated and serum 25 OH vitamin D are estimated.

Results: The diagnostic criteria for CKD like blood urea, serum creatinine and eGFR were significantly higher in CKD when compared to control. In the present study, systolic and diastolic blood pressure was significantly increased in CKD compared with control. The Carotid Intima Media Thickness (CIMT) both left and right side were significant higher in CKD when compared with control. There is a significantly decreased levels of serum vitamin D in CKD (14.53 ng/mL±6.88) when compared with control (28.87 ng/mL±6.28).

Conclusions: Present study finding suggested that there is a raised value of CIMT in CKD patients. High triglycerides, cholesterol and decreased HDL and declined vitamin D low hemoglobin, decreased eGFR, increased systolic blood pressure, raised CIMT value were found to be significantly increased in CKD patients.

References

Gooneratne IK, Ranaweera AK, Liyanarachchi NP, Gunawardane N, Lanerolle RD. Epidemiology of chronic kidney disease in a Sri Lankan population. Int J Diab Dev Ctries. 2008;28(2):60.

Wen CP, Cheng TY, Tsai MK, Chang YC, Chan HT, Tsai SP, et al. All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462293 adults in Taiwan. Lancet. 2008;371(9631):2173-82.

Singh AK, Farag YM, Mittal BV, Subramanian KK, Reddy SR, Acharya VN, et al. Epidemiology and risk factors of chronic kidney disease in India-results from the SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC Nephrol. 2013;14(1):114.

Levey AS, Beto JA, Coronado BE, Eknoyan G, Foley RN, Kasiske BL, et al. Controlling the epidemic of cardiovascular disease in chronic renal disease: what do we know? what do we need to learn? where do we go from here? national kidney foundation task force on cardiovascular disease. Am J Kidney Dis. 1998;32(5):853-906.

Artaza JN, Mehrotra R, Norris KC. Vitamin D and the cardiovascular system. Clin J Am Soc Nephrol. 2009;4(9):1515-22.

Melamed ML, Astor B, Michos ED, Hostetter TH, Powe NR, Muntner P. 25-hydroxyvitamin D levels, race, and the progression of kidney disease. J Am Soc Nephrol. 2009;20(12):2631-9.

Brewer LC, Michos ED, Reis JP. Vitamin D in atherosclerosis, vascular disease, and endothelial function. Curr Drug Targets. 2011;12(1):54-60.

Boer IH, Kestenbaum B, Shoben AB, Michos ED, Sarnak MJ, Siscovick DS. 25-hydroxyvitamin D levels inversely associate with risk for developing coronary artery calcification. J Am Soc Nephrol. 2009;20(8):1805-12.

London GM, Guérin AP, Verbeke FH, Pannier B, Boutouyrie P, Marchais SJ, et al. Mineral metabolism and arterial functions in end-stage renal disease: potential role of 25-hydroxyvitamin D deficiency. J Am Soc Nephrol. 2007;18(2):613-20.

Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation. 1986;74(6):1399-406.

Salonen JT, Salonen R. Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Arterioscler Thrombos Vasc Biol. 1991;11(5):1245-9.

Bowers LD. Kinetic serum creatinine assays I. The role of various factors in determining specificity. Clin Chem. 1980;26(5):551-4.

Tiffany TO, Jansen JM, Burtis CA, Overton JB, Scott CD. Enzymatic kinetic rate and end-point analyses of substrate, by use of a GeMSAEC fast analyzer. Clin Chem. 1972;18(8):829-40.

Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974;20(4):470-5.

Burstein M, Scholnick HR, Morfin R. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. Lipid Res. 1970;11(6):583-95.

McGowan MW, Artiss JD, Strandbergh DR, Zak B. A peroxidase-coupled method for the colorimetric determination of serum triglycerides. Clin Chem. 1983;29(3):538-42.

Rule AD, Larson TS, Bergstralh EJ, Slezak JM, Jacobsen SJ, Cosio FG. Using serum creatinine to estimate glomerular filtration rate: accuracy in good health and in chronic kidney disease. Ann Internal Med. 2004;141(12):929-37.

Raju DSSK, Lalitha DL, Kiranmayi. Observation of estimated GFR in the assessment of chronic kidney disease: application and practice. Asian J Pharmaceut Clin Res. 2012;5(4):201-6.

Zhang L, Zuo L, Wang F, Wang M, Wang S, Lv J, et al. Cardiovascular disease in early stages of chronic kidney disease in a Chinese population. J Am Soc Nephrol. 2006;17(9):2617-21.

Preston E, Ellis MR, Kulinskaya E, Davies AH, Brown EA. Association between carotid artery intima-media thickness and cardiovascular risk factors in CKD. Am J Kid Dis. 2005;46(5):856-62.

Kawagishi T, Nishizawa Y, Konishi T, Kawasaki K, Emoto M, Shoji T, et al. High-resolution B-mode ultrasonography in evaluation of atherosclerosis in uremia. Kidney Int. 1995;48(3):820-6.

Brzosko S, Lebkowska V, Malyszko J, Hryszko T, Krauze K, Mysliwiec M. Intima media thickness and presence of ischemic heart disease in hemodialysis patients. Physiol Res. 2005;54(5):497-504.

Vaziri ND, Liang K. Down-regulation of tissue lipoprotein lipase expression in experimental chronic renal failure. Kidney Int. 1996;50(6):1928-35.

Moberly JB, Attman PO, Samuelsson O, Johansson AC, Knight-Gibson C. Apolipoprotein C-III, hypertriglyceridemia and triglyceride-rich lipoproteins in uremia. Miner Electrolyte Metab. 1999;25(4-6):258-62.

Ponna AK, Farishta F. Carotid intima-media thickness in patients with chronic kidney disease. Indian J Appl Res. 2016;6:714-18.

Guarnieri GF, Moracchiello M, Campanacci L, Ursini F, Ferri L. Lecithin-cholesterol acyltransferase (LCAT) activity in chronic uremia. Kidney Int Suppl. 1978;(8):S26-30.

Kimura H, Miyazaki R, Imura T, Masunaga S, Suzuki S. Hepatic lipase mutation may reduce vascular disease prevalence in hemodialysis patients with high CETP levels. Kid Int. 2003;64(5):1829-37.

Raju DS, Lalitha DL, Kiranmayi P. A study of lipid profile and lipid peroxidation in chronic kidney disease with special reference to hemodialysis. J Clinic Res Bioeth. 2013;4(1):1000143.

Lim S, Shin H, Kim MJ; Ahn HY, Kang SM, Yoon JW, et al. Vitamin D effects endothelium in terms of calcium deposition and increased coronary artery calcification score. J Clin Endocrinol Metab. 2012;97(1):169-78.

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Published

2019-05-29

How to Cite

Behera, K. L., Varma, B. V. K. P., Raju, D. S. S. K., & Sayana, S. B. (2019). Status of vitamin D, lipid profile and carotid artery intima media thickness in patients with chronic kidney disease stage III to V. International Journal of Research in Medical Sciences, 7(6), 2292–2296. https://doi.org/10.18203/2320-6012.ijrms20192515

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Original Research Articles