Serum 1,25-Dihydroxyvitamin D Levels Across Stages of Chronic Kidney Disease: A Cross-Sectional Study in Bangladesh
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Abstract
Background: Chronic kidney disease (CKD) is associated with dysregulation of vitamin D metabolism and mineral homeostasis. Reduced renal activation of vitamin D leads to decreased circulating levels of 1,25-dihydroxyvitamin D and contributes to CKD-mineral and bone disorder (CKD-MBD). Understanding changes in active vitamin D levels across CKD stages may help identify metabolic complications associated with disease progression. Objective: To assess the serum levels of 1,25-dihydroxyvitamin D in patients with chronic kidney disease (CKD) stages G3-G5 and to assess its correlation with other laboratory parameters. Methods: This cross-sectional observational study was conducted in the Department of Nephrology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, from April to December 2020. A total of 75 patients with CKD stages G3–G5 were selected using purposive sampling. Clinical and laboratory data were collected from medical records and a semi-structured questionnaire. Serum 1,25-dihydroxyvitamin D and other biochemical parameters were analyzed. Independent sample t-test, one-way ANOVA, and Pearson correlation tests were used for statistical analysis. Results: The mean serum 1,25-dihydroxyvitamin D level was 26.00 ± 16.45 pg/mL. A progressive decline in serum 1,25-dihydroxyvitamin D levels was observed with advancing CKD stage. Mean levels were 32.78 ± 18.67 pg/mL in stage G3, 29.33 ± 16.27 pg/mL in stage G4, and 18.37 ± 10.17 pg/mL in stage G5, showing a statistically significant difference among stages (p = 0.007). Serum 1,25-dihydroxyvitamin D demonstrated a significant positive correlation with eGFR (r = 0.415, p < 0.001) and 25-hydroxyvitamin D (r = 0.259, p = 0.031). Conclusion: Serum 1,25-dihydroxyvitamin D levels decreased significantly with increasing CKD stage and were closely associated with kidney function and phosphorus metabolism. Dynamic monitoring of active vitamin D may help to identify CKD-MBD-related metabolic disorders in an early stage.
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