The Level Of Serum 1,25-dihydroxy Vitamin D3 And Its Correlation With Malnutrition And Residual Renal Function In Patients With Maintenance Peritoneal Dialysis

ObjectiveTo analyze the effect of peritoneal dialysis on serum 1,25-dihydroxy vitamin D3 level and the correlations between serum 1,25-dihydroxy vitamin D3 level and dialysis duration,malnutrition,residual renal function,peritoneal transport characteristics and other clinical factors.Methods The patients with ESRD were divided into ESRD group(30 cases)and CAPD group(93 cases).Thirty healthy subjects were enrolled as control group.The serum 1,25-dihydroxy vitamin D3 level was tested for all participants.According to the dialysis duration(one year,two years,three years or four years respectively),the CAPD patients were divided into group A(n=33),group B(n=28),group C(n=17)and group D(n=15).According to their peritoneal transport characteristics,the CAPD patients were also divided into high transport group(n=4),high average transport group(n=46),low average transport group(n=41)and low transport group(n=2).The correlation between serum 1,25-dihydroxy vitamin D3 level and dialysis duration,plasma albumin(albumin,Alb),residual renal function,C reactive protein(CRP),peritoneal transport characteristics and other clinical factors were analyzed.Results 1,The level of 1,25 hydroxyvitamin D3 in ESRD group(39.97 ± 5.10pmol/L)was significantly lower than that in the healthy group(47.20 ± 3.49pmol/L)(P = <0.05).The level of 1,25 hydroxyvitamin D3 in CAPD group(36.79 ± 5.90pmol/L)was significantly lower than that in ESRD group(P <0.05).2,The level of 1,25 hydroxyvitamin D3,the decreasing percentage of residual renal Kt/V,the decreasing percentage of residual renal Ccr after six months and level of plasma Alb were significantly different among groups A,B,C and D.The level of 1,25-dihydroxyvitamin D3 decreased gradually with the dialysis duration.3,The level of 1,25-dihydroxyvitamin D3 were negatively correlated with the decreasing percentage of residual renal Kt/V after six months(r=-0.647,P<0.01).The level of 1,25-dihydroxyvitamin D3 were negatively correlated with the decreasing percentage of residual renal Ccr after six months(r=-0.524,P<0.01).The level of 1,25-dihydroxyvitamin D3 were negatively correlated with CRP(r=-0.475,P<0.01).The level of 1,25-dihydroxyvitamin D3 were positively correlated with the level of Alb(r=0.663,P<0.01)in peritoneal dialysis patients.In the multivariate linear stepwise regression analysis,the level of 1,25-dihydroxyvitamin D3 in peritoneal dialysis patients was associated with 2 factors(the decreasing percentage of residual renal Kt/V after six months and the level of Alb)(both P <0.001)}.4,The level of 1,25 dihydroxyvitamin D3 was not significantly different between the high average transport group(36.72 + 5.22pmol/L)and the low average transport group(37.16 + 6.24pmol/L)(P=0.56).The levels of vitamin D3 in high transport + high average transport group and in low transport +low average transport group were both gradually decreased with the dialysis duration.Conclusion 1,The production of 1,25-dihydroxyvitamin D3 decreased due to renal failure in ESRD patiens.Peritoneal dialysis treatment also affected the serum level of 1,25 dihydroxyvitamin D3 in CAPD patients.2,The level of 1,25 dihydroxyvitamin D3 decreased with the duration of dialysis in CAPD patients.The level of 1,25 dihydroxyvitamin D3 was correlated with malnutrition and residual renal function,but not correlated with peritoneal transport characteristics in CAPD patients.