Ethnic differences in 25-hydroxyvitamin D levels and response to treatment in CKD |
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Authors: | Iris Sanchez Roberto Mangoo-Karim Jason R Stubbs George P Yanev James B Wetmore |
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Institution: | 1. South Texas Kidney Specialists, PA, McAllen, TX, USA 2. Division of Nephrology and Hypertension, Department of Medicine, University of Kansas Medical Center, MS 3002, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA 3. Department of Mathematics, University of Texas–Pan American, Edinburg, TX, USA
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Abstract: | Aim Nutritional vitamin D 25(OH)D] deficiency is common in patients with chronic kidney disease (CKD). No studies have specifically examined the differences between ethnic groups in response to ergocalciferol (“D2”) therapy. Methods A retrospective analysis was performed to evaluate the effectiveness of D2 therapy as recommended by the KDOQI guidelines in 184 Hispanic and Caucasian nondialysis CKD patients. Results Low 25(OH)D levels (<75 nmol/L) were found in 89.4 % of Hispanics versus 61.4 % of Caucasians, despite similar degrees of CKD. Treatment per KDOQI guidelines resulted in 85.5 % of treated Hispanics and 66.7 % of treated Caucasians remaining vitamin D-deficient. Although both Hispanics and Caucasians had significant (P < 0.0001) changes in 25(OH)D levels, absolute changes were modest (12.5 ± 2.0 nmol/mL in Hispanics, 20.0 ± 3.5 nmol/L in Caucasians). The increase seen in Caucasians was significantly greater than in Hispanics (P < 0.0001). In multiple logistic regression modeling, Hispanic ethnicity remained independently associated with poorer response to therapy (P = 0.0055), even after adjustment for other factors. Conclusions While both Hispanics and Caucasians demonstrated suboptimal response to the KDOQI-guided vitamin D repletion strategy, Hispanic ethnicity was significantly associated with poorer response. Our findings may have implications for other darker-skinned populations, even in solar-rich environments. |
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