THE VITAMIN D STATUS IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND ITS CONNECTION WITH CARDIAC AND VESSEL PATHOLOGY

THE AIM to determine the deficit frequency of 25 (OH) vitamin D (calcidiol – CD) and 1,25 (OH)₂ vitamin D (calcitriol – CT) in patients with chronic kidney disease (CKD) and its connection with the cardiac and vessel system state. PATENTS AND METHODS. 94 patents of 60,1±12,6 years of age with CKD stages 1-4, in most cases (91,5 %) suffering from diabetic nephropathy had a one time evaluation of the levels of CD and CT, lipidogram, the thickness of the intimae and media of the carotid arteries (CIM), echocardiography, ECG and BP monitoring. RESULTS. In the whole group the deficit of CD (< 3,75 pmol/l) was noted in 25,7 % of the patients, the CT deficit (< 53 pmol/l) – in 62,8 % and insufficiency of CD (<75 pmol/l) in 78,8 % of the patients. The level of CD, in patients evaluated in April – June was much lower than in those evaluated in September – December. The level of CT was reversely connected with the thickness of the back left ventricular wall (LV), BP level and directly connected with the glomerular filtration rate and the lipid of high density level. Besides that, CT was reversely correlated with the triglyceride level and with of the calcinosis of aorta extend (CAA). The CD level was directly connected with the diastolic function of the LV and reversely with the presence of IHD, thickness of the intima-media complex of the carotid arteries, and the presence of heart failure (HF). CONCLUSION. The deficiency of CD can be seen in patients with CKD more often than in the total population and the level of CD is dependant on the season. The low values of CT are combined with more eminent CAA and cardiac valve, hypertension, hypertrophy of the left ventricle, dislipidemia. The low values of CD are associated with more frequent risks of ICD, HF, diastolic myocardial dysfunction, calcinosis of cardiac valves.

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