Main Article Content
Acute renal failure (ARF) has traditionally been defined as the abrupt loss of kidney function that results in retention of urea and other nitrogenous waste products and dysregulation of extracellular volume and electrolytes (1). 25(OH)D deficiency prior to hospital admission might be linked to acute kidney injury in a critically ill patient population (2). Eighty patients were selected from ICU of Ahmed Maher Teaching Hospital, and informed consent was obtained from all patients. This study was approved ethically by the local authority of the hospital and the patients were concented to do this study. The selected patients were subjected to: history taking, full clinical examination, laboratory investigations, serum 25-hydroxyvitamin D, blood urea and serum creatinine, eGFR, CBC,serum calcium,serum phosphorus, lipid profile, serum albumin, fasting and 2h postprandial blood sugar and urine analysis. There was significant difference between groups on regard age (AKI group was 58.2±10.6 and non AKI group 65.1±11.3). There was significant association between mortality and AKI as 20% of AKI group died while no one in other group died. There was significant association between 25 (OH)D deficiency and AKI as 75% of AKI group had 25 (OH)D deficiency while other group hadn’t any one. There was significant association between mortality and 25 (OH)D deficiency as 26.7% of 25 (OH)D deficiency group died while no one in other group died. There was significant association between 25 (OH)D deficiency and AKI as 100% of 25 (OH)D deficiency had AKI while 7.7% only of other group had AKI. There was significant association between AKI and level of 25 (OH)D and kappa for agreement was 0.95. 25 (OH)D was a high validity tool for detection of AKI. There was significant association between mortality and level of 25 (OH)D and kappa for agreement was 0.84. 25 (OH)D was high validity tool for detection of mortality. GFR<90 , UTI, DM, high level of serum creatinine and high level of blood urea were significant risk factors for AKI and 25 (OH)D deficiency was a highly significant risk factors for AKI. AF, GFR<90 , high level of creatinine and high level of urea were significant risk factors for mortality and 25 (OH)D deficiency was highly significant risk factors for mortality Deficiency of 25-hydroxyvitamin D is a significant predictor of acute kidney injury and mortality in a critically ill patient population.
How to Cite
ELBARBARY, Hany S. et al. Study of serum 25-hydroxyvitamin D in critically ill patients with acute kidney injury. JOURNAL OF ADVANCES IN BIOLOGY, [S.l.], v. 6, n. 1, p. 825-834, jan. 2017. ISSN 2347-6893. Available at: <https://cirworld.com/index.php/jab/article/view/5465>. Date accessed: 21 nov. 2017.
Vitamin D;acute kidney injury.
This work is licensed under a Creative Commons Attribution 4.0 International License.
(1) Mehta RL,Chertow GM. (2003):Acute renal failure definition and classification :time for change ?Am Soc Nephrol ;14(8)2178. (2) Braun A, Gibbons FK, Litonjua AA, et al. (2012): low serum 25-hydroxyvitamin D at critical care initiation is associated with increased mortality. Crit Care Med; 40(1):63–72. (3) Jim Cassidy,Donanld bissett,Roy A. J.Spence,Mranda Payne (2010) :Oxford Handbook of Oncology Oxford University Press. P.706.(4) Papadakis MA,Mcphee SJ. (2008) : Current Medical Diagnosis and Treatment. McGraw-Hill Professional.ISBN 007-159124-9. (5) Mehta RL, Kellum JA, Shah SV, et al. (2007) : Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury". Critical Care (London, England) 11 (2): R31 (6) Palevsky PM, Zhang JH, O'Connor TZ, et al. (2008): Intensity of renal support in critically ill patients with acute kidney injury". The New England Journal of Medicine 359 (1): 7–20. (7) Holmes CL, Walley KR . (2003) :Bad medicine: low-dose dopamine in the ICU. Chest 123 (4): 1266–75. (8) Uchino S, Doig GS, Bellomo R, et al. (2004): Diuretics and mortality in acute renal failure". Crit. Care Med. 32 (8): 1669–77. (9) BAGSHAW SM, DELANEY A, HAASE M, ET AL (2007): Loop diuretics in the management of acute renal failure: a systematic review and meta-analysis. Crit Care Resusc; 9(1):60-8. (10) Holick MF ( 2007): Vitamin D deficiency. N Engl J Med; 357:266–281 (11) Norman AW (2008): From vitamin D to hormone D: Fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr; 88:491S–499S. (12) Levey SA, Coresh J, Balk E, et al.( 2003): National kidney foundation practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Ann. Intern. Med; 139(2):137-147. (13) -Holick MF (2009): Vitamin D Status: Measurement, Interpretation, and Clinical Application, Annals of Epidemiology, Feb; 19(2):73-8. (14) Feest TJ, Round A, Hamad S (1993): Incidence of severe acute renal failure inadults: results of a communitybased study. BMJ 306: 481–483. (15) Wiedermann CJ, Wiedermann W, Joannidis M (2010): Hypoalbuminemia and acute kidney injury: a metaanalysis of observational clinical studies. Intensive Care Med.;36(10):1657-65. (16) RodrigoCartinCeba, MarkosKashiouris, MariaPlataki (2012):Risk Factors for Development of Acute Kidney Injury in Critically Ill Patients: A Systematic Review and Meta-Analysis of Observational StudiesVolume 2012 Article ID 691013, 15 pages (17) Andrea B. Braun, MD; Augusto A. Litonjua, MD, (2012): Association of low serum 25-hydroxyvitamin D levels and acute kidney injury in the critically ill. Crit Care Med Vol. 40, No. 12. (18) Chiu PF, Huang CH, Liou HH, Wu CL, Wang SC, Chang CC.(2013): Long-term renal outcomes of episodic urinary tract infection in diabetic patients J Diabetes Complications.;27(1):41-3. (19) Ishir Bhan, Sherri-Ann M. Burnett-Bowie,Jun Ye, Marcello Tonelli, and Ravi Thadhani (2010):Clinical Measures Identify Vitamin D Deficiency in Dialysis. Clin J Am Soc Nephrol.; 5(3): 460–467. (20) Palomer X, González-Clemente JM, Blanco-Vaca F, Mauricio D (2008): Role of vitamin D in the pathogenesis of type 2 diabetes mellitus. Diabetes Obes Metab.;10(3):185-97. (21) Braun AB and Christopher KB. (2013): Vitamin D in acute kidney injury. Inflamm Allergy Drug Targets; 12(4): 26272