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Schuchart DM, Becker I, Harbeck B, Röhrig G. Association between anemia and vitamin D deficiency in German seniors : A retrospective data analysis. Z Gerontol Geriatr 2024:10.1007/s00391-024-02322-3. [PMID: 38967671 DOI: 10.1007/s00391-024-02322-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/22/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Anemia and deficiency of vitamin D (VDD) are frequently seen in seniors and an association is suspected. Approximately one third of the German population is affected by VDD, with a rising prevalence among seniors. AIM To analyze the association between anemia and VDD among German seniors aged ≥ 60 years. METHODS Retrospective cross-sectional data analysis (n = 4008) in a nationwide working laboratory medical center (January-December 2019). Study parameters included amongst others: hemoglobin (Hb), calcifediol (25D) and calcitriol (1.25D), glomerular filtration rate (GFR) to assess the kidney disease outcomes quality initiative (KDOQI) state. The inclusion criteria were age ≥ 60 years, normal C‑reactive protein (CRP) and leucocyte levels. RESULTS The 25D was estimated in 4008 patients and 1.25D only in 411 patients. Mean age 75 years (± 8.61 years; 60-99 years) with 30.6% males; mean GFR 62 ml/min/1.73 m3 (± 22.74); 20% of patients were anemic, 35% were deficient for 25D (< 50 nmol/l), with men > women (p = 0.014). Linear regression analysis revealed a significant effect of 25D values < 30 nmol/l on hemoglobin in males of KDOQI I-III and females of KDOQI I-IV (R2 = 0.052; p = 0.005; and R2 = 0.124; p < 0.001, respectively). For 1.25D a weak but significant effect on hemoglobin independent of KDOQI was only seen in women (R2 = 0.200; p = 0.005). CONCLUSION In this cohort deficiency of 25D and 1.25D was significantly associated with hemoglobin independent of renal function only in women but not in men.
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Affiliation(s)
| | - Ingrid Becker
- Institute of Medical Statistics and Computational Biology, University Cologne, Cologne, Germany
| | - Birgit Harbeck
- Germany and III. Department of Medicine, University Medical Center Hamburg-Eppendorf, amedes medical specialist center of endocrinology and osteology, Hamburg, Germany
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriele Röhrig
- European University of Applied Sciences (EUFH), Neusser Straße 99, 50670, Cologne, Germany.
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Tang Y, Guo J, Zhou J, Wan Z, Li J, Qiu T. Risk factors and current state of therapy for anemia after kidney transplantation. Front Med (Lausanne) 2024; 10:1170100. [PMID: 38264045 PMCID: PMC10804853 DOI: 10.3389/fmed.2023.1170100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 12/19/2023] [Indexed: 01/25/2024] Open
Abstract
Post-transplant anemia is one of the most common complications in kidney transplant recipients, severely affecting patient prognosis and quality of life, and is an independent predictor of graft kidney loss and patient mortality. However, our clinical understanding and the attention given to post-transplant anemia are currently insufficient. This paper reviews the current status, risk factors, and therapeutic progress in anemia after transplantation in kidney transplant recipients. We recommend that clinical staff pay attention to anemia and its complications in kidney transplant recipients and intervene early for anemia.
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Affiliation(s)
- Yan Tang
- The Department of Organ Transplantation, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jiayu Guo
- The Department of Organ Transplantation, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jiangqiao Zhou
- The Department of Organ Transplantation, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Zijie Wan
- The Department of Organ Transplantation, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jinke Li
- The Department of Organ Transplantation, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Tao Qiu
- The Department of Organ Transplantation, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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Emarah SM, Ahmed MAER, El Kannishy GM, Abdulgalil AE. Effect of vitamin D supplementation on management of anemia in hemodialysis patients with vitamin D deficiency: A double-blind, randomized, controlled trial. Hemodial Int 2024; 28:51-58. [PMID: 37853507 DOI: 10.1111/hdi.13121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Anemia and vitamin D deficiency are common problems among hemodialysis (HD) patients. This study aimed to assess the impact of correction of vitamin D deficiency with vitamin D supplementation on the improvement of anemia in patients with end-stage renal disease (ESRD) on maintenance HD. METHODS This double-blind, randomized, controlled study included 100 anemic HD patients with vitamin D deficiency who were randomly divided using the closed envelop method into two groups (1:1). The first group received vitamin D (50,000 IU) monthly for 6 months, and the other group received a placebo for the same period. 25-Hydroxyvitamin D (25(OH)D) levels were measured for both groups at the beginning of the study and after 6 months at the end of the study. Hemoglobin (Hb) concentrations were recorded monthly. FINDINGS Vitamin D supplementation during the period of the study increased 25(OH)D levels in the vitamin D group more than the placebo group (p > 0.001). Serum ferritin, serum iron, and transferrin saturation did not differ significantly between both groups during the period of the study. Hb concentration in the vitamin D group increased more than that in the other group over the period of the study, and there was a statistically significant difference between the two groups in all durations of follow-up. Erythropoietin (EPO) dosage requirements were found to be lower in the vitamin D group than in the placebo group, and this was statistically significant (p > 0.001). DISCUSSION Vitamin D supplementation in anemic ESRD patients on HD with vitamin D deficiency or insufficiency is safe and effective in improving anemia and decreasing EPO dosage.
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Affiliation(s)
| | | | - Ghada Mohamed El Kannishy
- Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Elsaeed Abdulgalil
- Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Li M, Xu J, Wan Q, He Q, Ma Y, Tang YQ, Peng HY. Relationship between serum vitamin D3 concentration and anaemia in patients with chronic kidney disease in China. J Int Med Res 2021; 49:3000605211012231. [PMID: 34018838 PMCID: PMC8150523 DOI: 10.1177/03000605211012231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objective In the present study, we aimed to investigate the relationship between serum vitamin D3 concentration and anaemia in patients with chronic kidney disease (CKD) in China, to assist understanding of the effects of vitamin D treatment in such patients. Methods A total of 225 patients with CKD were enrolled and a range of laboratory parameters were measured. The participants were allocated to three groups, according to their serum 25-hydroxyvitamin D3 concentration: a severe deficiency group, a deficiency group, and a sufficiency group. The prevalences of anaemia in the three groups were assessed, and the factors associated with anaemia in patients with CKD were analysed using logistic regression. Results The prevalences of anaemia were 79.5% in the severe deficiency group, 63.5% in the deficiency group, and 48.0% in the sufficiency group. The prevalence of anaemia gradually increased with the severity of vitamin D3 deficiency. The prevalences of anaemia in participants with stages 1 to 5 CKD were 21.1%, 30.4%, 39.5%, 78.7%, and 94.6%, respectively. Conclusion Vitamin D3 deficiency may increase the risk of anaemia in patients with CKD.
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Affiliation(s)
- Meng Li
- Department of Pneumology, Bijie Hospital of Traditional Chinese Medicine, Guizhou, China.,Guizhou Medical University, Guizhou, China
| | - Jun Xu
- Department of Nephrology, Affiliated Baiyun Hospital of Guizhou Medical University, Guizhou, China
| | - Qin Wan
- Department of Nephrology, Qianxi County People's Hospital, Guizhou, China
| | - Qiang He
- Department of Nephrology, Pingba County People's Hospital, Guizhou, China
| | - Yan Ma
- Department of Nephrology, Affiliated Baiyun Hospital of Guizhou Medical University, Guizhou, China
| | - Ying-Qian Tang
- Department of Nephrology, Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Hong-Ying Peng
- Department of Nephrology, Affiliated Baiyun Hospital of Guizhou Medical University, Guizhou, China
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Sah SK, Adhikary LP. Association Between Dyslipidemia and Serum Level of 25-Hydroxyvitamin-D in Early Chronic Kidney Disease, Not on Dialysis: An Observational Cross-Sectional Study from the Himalayan Country. Int J Nephrol Renovasc Dis 2020; 13:211-218. [PMID: 33061530 PMCID: PMC7522427 DOI: 10.2147/ijnrd.s267252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/24/2020] [Indexed: 11/23/2022] Open
Abstract
Background Patients with CKD have a higher prevalence of dyslipidemia and hypovitaminosis than the normal population. Recent studies in the general population have shown a potential link between 25(OH)D and dyslipidemia. However, such evidence in the early CKD population, especially in the Nepalese setting, is lacking. Thus, the present study aimed at investigating the status of 25(OH)D and dyslipidemia in the early CKD patients, and further to establish an association between 25(OH)D and lipid profile. Patients and Methods In this cross-sectional study, we analyzed 136 clinically stable non-dialyzed CKD patients. 25(OH)D and lipid profile were evaluated as a core variable, and their direction and magnitude of a relationship were evaluated. Results The estimated prevalence of dyslipidemia was 49.3%, and 63.2% population had a deficiency of 25(OH)D level. Compared with the patient with normal 25(OH)D level, the patient with deficient 25(OH)D level had a significantly higher level of LDL-c (P=0.04) and lower level of HDL-C (P=0.048). Serum 25(OH)D level was significantly lower in dyslipidemic patients than non-dyslipidemic patients (P=0.015). Regression analysis demonstrated a significant inverse relationship between serum 25(OH)D levels and LDL-c (β=−1.5; P=<0.001), and TC levels (β=−1.4;P=0.003), and the association remained unchanged with further adjustment for age, sex, HTN, DM, serum albumin and eGFR. Conclusion Our study unveiled a high rate of dyslipidemia and hypovitaminosis in a considerable number of early CKD patients. Low serum level of 25(OH)D was significantly correlated with a higher rate of dyslipidemia. These findings indicate some evidence for 25(OH)D level as a marker of dyslipidemia prediction, and that decrease in serum level of 25(OH)D is associated with increased serum level of LDL and TC; it could increase the risk of cardiovascular disease. Therefore, early recognition and timely management of hypovitaminosis and dyslipidemia is vital to prevent an inevitable cardiovascular event.
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Affiliation(s)
- Shiv Kumar Sah
- Department of Pharmacy, Purbanchal University, Little Buddha College of Health Science, Kathmandu, Nepal.,Gastro and Liver Foundation, Kathmandu, Nepal
| | - Laxman Prasad Adhikary
- Nephrology Unit, Department of Medicine, Kathmandu Medical Hospital Teaching Hospital, Kathmandu, Nepal
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Al-Amad SH, Hasan H. Vitamin D and hematinic deficiencies in patients with recurrent aphthous stomatitis. Clin Oral Investig 2019; 24:2427-2432. [DOI: 10.1007/s00784-019-03102-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022]
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Houghton LA, Trilok-Kumar G, McIntosh D, Haszard JJ, Harper MJ, Reid M, Erhardt J, Bailey K, Gibson RS. Multiple micronutrient status and predictors of anemia in young children aged 12-23 months living in New Delhi, India. PLoS One 2019; 14:e0209564. [PMID: 30735503 PMCID: PMC6368289 DOI: 10.1371/journal.pone.0209564] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 12/07/2018] [Indexed: 02/07/2023] Open
Abstract
Anemia has been identified as a severe public health concern among young children in India, however, information on the prevalence of anemia attributed to micronutrient deficiencies is lacking. We aimed to assess multiple micronutrient status (iron, zinc, selenium, vitamin A, vitamin D, folate and vitamin B12) in young Indian children and to investigate the role of these seven micronutrients and other non-nutritional factors on hemoglobin concentrations and anemia. One-hundred and twenty children aged 12 to 23 months were included in a cross-sectional nutritional assessment survey, of which 77 children provided a blood sample. Hemoglobin (Hb), serum ferritin, soluble transferrin receptor (sTfR), total body iron, zinc, selenium, retinol binding protein (RBP), folate, vitamin B12 and 25-hydroxyvitamin D (25(OH)D) were measured, and adjusted for inflammation using C-reactive protein (CRP) and α-1-acid glycoprotein (AGP), where appropriate. Predictors for hemoglobin and anemia were identified in multiple regression models. Most of the children were classified as anemic, of which 86 to 93% was associated with iron deficiency depending on the indicator applied. Deficiencies of folate (37%), and notably vitamin D (74%) were also common; fewer children were classified with deficiencies of vitamin B12 (29%), zinc (25%), and vitamin A (17%) and selenium deficiency was nearly absent. Multiple micronutrient deficiencies were common with over half (57%) deficient in three or more micronutrients, and less than 10% of children were classified with adequate status for all the micronutrients measured. Iron status was found to be the only nutritional factor statistically significantly inversely associated with anemia (P = 0.003) in multivariate analysis after controlling for sex. A coordinated multi-micronutrient program is urgently needed to combat the co-existing micronutrient deficiencies in these young children to improve micronutrient status and reduce the high burden of childhood anemia.
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Affiliation(s)
- Lisa A. Houghton
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
- * E-mail:
| | - Geeta Trilok-Kumar
- Department of Biochemistry, Institute of Home Economics, University of Delhi, New Delhi, India
| | - Deborah McIntosh
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Jillian J. Haszard
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Michelle J. Harper
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Malcolm Reid
- Department of Chemistry, University of Otago, Dunedin, New Zealand
| | | | - Karl Bailey
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Rosalind S. Gibson
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Sonkar SK, Singh HP, Sonkar GK, Pandey S. Association of Vitamin D and secondary hyperparathyroidism with anemia in diabetic kidney disease. J Family Med Prim Care 2018; 7:815-818. [PMID: 30234059 PMCID: PMC6131998 DOI: 10.4103/jfmpc.jfmpc_174_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Introduction: Anemia is common in Chronic Kidney Disease (CKD) and diabetes is a major leading risk factor for it. In Diabetic Kidney Disease (DKD), it worsens more, which further increases cardiovascular morbidity and mortality. Despite of adequate iron stores anemia persist, which may be due to impaired iron release from body stores that is unable to meet the demand for erythropoiesis (also called reticuloendothelial cell iron blockade). High parathyroid hormone (PTH) along with vitamin D, may be attributable for anemia. Methods: A cross-sectional study of 150 advanced (Stage 4 & 5) pre dialyzed DKD patients (GFR <30ml/min/1.73 m2), aged 40-70 years were included over a period of 1 year. Any other concomitant illness/ drugs leading to anemia were excluded. Serum samples were collected and urea, creatinine, hemoglobin, iron profile, vitamin D, iPTH, uric acid, calcium, phosphorous and albumin levels were measured. A data base was constructed on Microsoft Excel 2007 and statistical analyses were performed using the SPSS software version 20.0 (IBM, NY, USA). Results: Stage 5 DKD had more pronounced anemia compared to stage 4 DKD (P < 0.001). Hemoglobin (Hb) was inversely correlated with iPTH (r = -0.74, P < 0.001) and was associated with vitamin D deficiency (r = 0.51, P < 0.001) but not with serum ferritin. DKD patients with low eGFR (r = -0.6, P < 0.001), vitamin D (r = -0.43, P < 0.001) and serum calcium (r = -0.37, P < 0.001) had higher iPTH. Secondary hyperparathyroidism (beta=-0.005; P < 0.001) and Vitamin D (beta=0.053; P < 0.01) were strong predictor for Hb while parameters of iron profile was not statistically significant. Conclusion: An efficient control of PTH hypersecretion is therefore required to achieve a better management of anemia as well as mineral metabolism in DKD patients.
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Affiliation(s)
- Satyendra Kumar Sonkar
- Department of Medicine, Dialysis Unit, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Harendra Pratap Singh
- Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gyanendra Kumar Sonkar
- Department of Biochemistry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sant Pandey
- Department of Nephrology, King George's Medical University, Lucknow, Uttar Pradesh, India
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