الفهرس 
Vitamin DOnly 14 pages are availabe for public view
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Abstract
Patients with chronic kidney disease are frequently suffering from the deficiency of 1,25-dihydroxyvitamin D3 (calcitriol) due to the lack of its precursor–25-hydroxyvitamin D3, and also due to the decreased activity of kidney enzyme 1α-hydroxylase, which converts this precursor into active hormone
In patients suffering from chronic kidney disease (CKD), the prevalence of cardiovascular disease is much more common than in the general population. Their high morbidity and mortality cannot be explained by traditional cardiovascular risk factors.
This study aimed to evaluate the role of vitamin D deficiency in chronic kidney disease patients, with and without dialysis and its impact on cardio vascular morbidity If fetal or not fatal.
In group A (control) included 10 males and 15 females, their mean age was 42.56±3.1 years, group B (CKD) included 27 males and 23 females, their mean age was 41.6±2.5 years, group C (CKD+ dialysis) included 12 males and 13 females, their mean age was 43.3±2 years. There was no statistical difference between groups regarding gender, while there was a statistical difference between groups regarding age (p=0.022).
Vitamin D was statistically higher in group A (36±7.4) than group B (17±2.5), and group C (11.4±1.5), p<0.001. And between group B&C, p<0.001. 72% of group A have normal vitamin D level and 28% had insuffiecent vit D level, in group B; 16% of patients had insufficient vit. D and 84% had vit D deficiency, in group C; 80% had vit D deficiency, and 20 % had sever vit. D deficiency, there was a statistical difference between group, p<0.001.
The group with normal ECG had statistically higher levels of vitamin D (mean= 24.5±10.8) compared to the group with abnormal ECG (mean= 13.9±4.1), p<0.001.
There was statistical difference between group B and C regarding repeated measures of vitamin D, in group B; the mean vitamin D was 17±2.5, at 3 months was 20.9±2.9, at 6 months was 25±3.3, and at 9 months was 32±5.3, while in group C; the mean vitamin D was 11.4±1.5, at 3 months was 12.8±1.8, at 6 months was 17.7±1.3, and at 9 months was 22.3±1.4. p<0.001.
Eight patients of group B (16%) died during the study period, compared to 3 patients (12%) of group C, there was no statistical difference between groups regarding status of death. On comparison between alive and died patients regarding the clinical data; there was no statistical difference between groups regarding age, gender, presence of symptoms or ECG abnormality. There was no statistical difference between groups regarding levels of Hb, Plt, Urea, creatinine, total Ca, ionized Ca, Po4, and potassium. While there was statistical difference between group regarding PTH (statistically higher in alive group, p=0.025). and vit D was statistically higher in alive group, p=0.04.
Vitamin D could predict ECG abnormality with AUC=0.859. And at cutoff value of 17.650, the sensitivity was 0.769, and specificity was 0.731. And could predict mortality with AUC=0.758. And at cutoff value of 19.650, the sensitivity was 0.858, and specificity was 0.717.
There was no significant correlation between vitamin D and age, while there was significant positive correlation between vitamin D and (Hb, Plt, and total Ca), and there was significant negative correlation between vitamin D and (urea, creatinine, PTH, ionized Ca, Po4, and K).