Vitamin D level and other biochemical parameters of mineral bone disorders and its association with left ventricular mass and diastolic dysfunction in young non-diabetic adult patients with chronic kidney disease

Dr. HARENDRA PRATAP SINGH; Dr. MAYANK SHAH; Dr. SUSHIL CHAVAN

Volume : VIII, Issue : III, March - 2019

Vitamin D level and other biochemical parameters of mineral bone disorders and its association with left ventricular mass and diastolic dysfunction in young non-diabetic adult patients with chronic kidney disease

Dr. Harendra Pratap Singh, Dr. Mayank Shah, Dr. Sushil Chavan

Abstract :

Introduction: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with end–stage renal disease (ESRD). Chronic kidney disease (CKD) associated cardiovascular mortality is seen higher in diastolic heart failure and it is an early predictor. Hypovitaminosis D is extensively being studied as a nontraditional risk factor for CVD. The aim of the present study is to look into the association of vitamin D and other parameters of mineral bone disorder (MBD) with diastolic dysfunction and left ventricular mass (LVM) in non–diabetic young adult patients with CKD. Materials and Methods: The present study was a hospital based cross sectional observational study in patients attending nephrology unit ,ikdrc.Group I and II consisted of non–diabetic pre–dialysis CKD (stage 4 & 5) patients and healthy controls respectively. Group IA and IB consisted of cases with diastolic dysfunction and cases without diastolic dysfunction respectively. Vitamin D level was measured by Enhanced chemiluminescence method and iPTH by ElectroChemiluminescence method. Parameters for diastolic function and left ventricular mass was assessed by Doppler echocardiography, tissue Doppler imaging and M–mode echocardiography. Results: Vitamin D level was significantly lower in group I as compared to group II. Diastolic dysfunction was present in 48.84% among cases. Diastolic dysfunction was significantly associated with calcium phosphorous product but not with vitamin D. A statistically significant positive correlation between LVMI and iPTH was found in our study. Conclusions: Calcium phosphorous product can be better predictor for diastolic dysfunction than Vitamin D and hence early predictor of cardiovascular mortality in pre–dialysis CKD patients.