만성 콩팥병 환자에서 추정 사구체 여과율에 따른 25-Hydroxyvitamin D의 특성
분야
의약학 > 내과학
저자
김태균 ( Tae Kyun Kim ) , 이수봉 ( Soo Bong Lee ) , 박창준 ( Chang Jun Park ) , 성은영 ( Eun Young Seong ) , 곽임수 ( Ihm Soo Kwak ) , 송상헌 ( Sang Heon Song ) , 고정희 ( Jung Hee Koh ) , 이하린 ( Harin Rhee ) , 오상보 ( Sang Bo Oh )
발행기관
대한내과학회
간행물정보
Korean Journal of Medicine(구 대한내과학회지) 2012년, 제83권 제6호, 740~751페이지(총12페이지)
파일형식
42847588.pdf [무료 PDF 뷰어 다운로드]
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    영문초록
    Background/Aims: Accumulating data suggest that vitamin D deficiency is prevalent in patients with chronic kidney disease (CKD). However, comprehensive data are lacking for Koreans. The aim of this study was to survey vitamin D deficiency among patients with CKD in Korea and to identify the relationships among various factors. Methods: We conducted a retrospective cohort study of 444 patients who were divided into four subgroups by estimated glomerular filtration rate (eGFR) for comparisons of mean 25-hydroxyvitamin D [25(OH)D] level and other parameters. In addition, non-dialyzed patients were categorized into four groups based on 25(OH)D levels (<10, 10-19, 20-29, and ≥ 30 ng/mL), and risk factors for severe vitamin D deficiency (<10 ng/mL) were investigated. Results: Of patients with an eGFR ≥ 60 mL/min/1.73 m2, 43% (34/79) showed severe 25(OH)D deficiency, and the mean 25(OH)D level was 11.7±5.3 ng/mL. In CKD3 group, 53.2% (41/77) showed severe 25(OH)D deficiency, with a mean level of 11.3±7.2 ng/mL. In CKD4 group, 53.3% (49/92) had severe 25(OH)D deficiency, with a mean level of 11.0±6.2 ng/mL. Approximately 71% (139/196) of patients in CKD5 group showed severe deficiency, and the mean level was 9.2±5.9 ng/mL. Severe 25(OH)D deficiency was affected by winter season, renal function, diabetes, and low-density lipoprotein cholesterol. The serum parathyroid hormone level was inversely correlated with the 25(OH)D level, such that 25(OH)D < 20 ng/mL were associated with a steep increase in parathyroid hormone. Conclusions: Vitamin D deficiency is highly prevalent in the Korean population. Few patients met a sufficient 25(OH)D concentration, even in the early stages of CKD. Our data suggest that 25(OH)D level of 20 ng/mL is a threshold for a rapid increase in parathyroid hormone levels. (Korean J Med 2012;83:740-751)
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