慢性肾病患者血1,25-二羟基维生素D3水平变化

目的 研究慢性肾病(CKD)患者血1,25-二羟基维生素D3(维生素D3)水平异常与肾功能受累程度的关系.方法 研究对象包括150例健康对照者和101例CKD患者,检测其血维生素D3、甲状旁腺素、钙、磷、肌酐、清蛋白及尿素氮水平,计算肾小球滤过率(GFR).结果 与对照组相比,第4~5期患者的血维生素D3水平显著降低(P<0.05),第3~5期患者的血甲状旁腺素(PTH)、肌酐及尿素氮(BUN)水平显著升高(P<0.05),第4~5期患者的血磷水平显著升高(P<0.05),各期CKD患者的清蛋白水平均显著降低(P<0.05),仅第5期CKD患者的血钙浓度显著降低(P<0.05).血维生素D3水平与血PTH、尿素氮及肌酐水平呈负线性相关关系,与血钙、清蛋白及GFR水平呈正线性相关关系.结论 第4~5期CKD患者缺乏维生素D3,说明只有当肾功能受损严重时,CKD患者血维生素D3水平才会出现明显异常.此外,本研究还表明CKD患者血维生素D3水平与其他肾功能相关生化指标存在一定的相关性.

Changes of blood 1,25-dihydroxyvitamin D3 level in patients with chronic kidney disease

Objective To understand the relationship between blood 1,25-dihydroxyvitamin D3 (vitamin D3) level and renal impairment in patients with chronic kidney disease (CKD).Methods 150 cases of healthy controls(control group) and 101 cases of CKD patients were enrolled and blood level of vitamin D3,parathyroid hormone (PTH),calcium,phosphorus,creatinine,albumin and blood urea nitrogen (BUN) were determined.Meanwhile,glomerular filtration rate (GFR) was calculated.Results Compared with control group,the blood vitamin D3 level of CKD patients at stages 4-5,albumin level of CKD patients at all stages and calcium level of only patients at stage 5 were significantly decreased (P<0.05),but blood phosphorus level of patients at stage 4-5 and the PTH,creatinine and BUN levels of CKD patients at stages 3-5 were increased (P<0.05).Significantly negative correlations between blood vitamin D3 level and blood PTH,creatinine and BUN levels and positive correlations between blood vitamin D3 level and blood calcium,albumin and GFR level were confirmed (P<0.05).Conclusion CKD patients at stages 4-5 might be deficient with vitamin D3,indicating that there could be obvious abnormality of blood vitamin D3 level in CDK patients,only when the renal impairment was severe.Meanwhile,the present study also shows that there are some relationships between blood vitamin D3 level and other biochemical indicators of renal function in CKD patients.