January - March 2024, Volume 20, Issue 1

Chiriac C, Ciurea OA, Lipan M, Capusa CS, Mircescu G

Vitamin D Deficiency, Bone Turnover Markers and Arterial Calcifications in Non-Dialysis Chronic Kidney Disease Patients

Acta Endo (Buc) 2024, 20 (1): 12-20
doi: 10.4183/aeb.2024.12

Introduction. Vitamin D [25(OH)D] deficiency is prevalent in chronic kidney disease (CKD), related to bone turnover and potentially involved in arterial calcifications. Objective. To evaluate vitamin D status in nondialysis CKD patients and its relationships with bone turnover markers (BTM) and arterial calcifications. Design. Cross-sectional, prospective, multicentric study. Subjects and methods. One hundred twenty-eight CKD patients (median age 61 years, 58% males, median eGFR 29mL/min) were included. Comorbidities, mineral and bone metabolism parameters were evaluated. Total alkaline phosphatase (T-ALP) was used to assess bone turnover. Atherosclerosis was evaluated by carotid intima-media thickness (CIMT), endothelial calcifications by aortic calcification score (ACS), and arterial stiffness by cardio-ankle vascular index (CAVI). Vitamin D deficiency was defined as 25(OH)D <15 ng/mL. Factors associated with vitamin D, T-ALP and vascular parameters were assessed in multivariate regression models. Results. Prevalence of vitamin D deficiency was 63% and median 25(OH)D was 12.8 ng/mL. Older age, female sex and higher parathormone were predictors of vitamin D deficiency. Increased T-ALP was predicted by higher parathormone, suggesting high turnover bone disease. While age was a determinant of all evaluated vascular parameters, lower 25(OH)D was associated only with endothelial calcifications, which correlated with CAVI, suggesting a direct relation between vitamin D deficiency mediated plaques calcification and arterial stiffness. Conclusion. Vitamin D deficiency was highly prevalent in this non-dialysis CKD cohort and was related to age, sex and parathormone. Vitamin D deficiency was associated with increased calcifications of endothelial plaques, which seemed to increase arterial stiffness.

Keywords: vitamin D deficiency, chronic kidney disease, predictors, vascular calcifications, arterial stiffness , mineral and bone disorder, bone turnover markers

Correspondence: Cristina Stela Capusa MD, “Carol Davila” Nephrology Hospital - Nephrology Department, 4 Calea Grivitei, Bucharest 010731, Romania, E-mail: cristinascapusa@gmail.com