Ashuntantang, Gloria E. University of Yaoundé 1 - Faculty of Medicine Biomedical Sciences - Dept of Internal Medicine Specialties, Cameroun , Anakeu, Aurélien T. University of Yaoundé I - Faculty of Medicine and biomedical sciences - Department of Medicine and clinical specialties, Cameroon , Doualla, Marie-Solange University of Yaoundé I - Faculty of Medicine and biomedical sciences - Department of Medicine and clinical specialties, Cameroon , Halle, Marie P. University of Douala - Faculty of Medicine and pharmaceutical sciences - Department of Medicine and clinical specialties, Cameroon , Kaze, François J. University of Yaoundé I - Faculty of Medicine and biomedical sciences - Department of Medicine and clinical specialties, Cameroon , Menanga, Alain P. University of Yaoundé I - Faculty of Medicine and biomedical sciences - Department of Medicine and clinical specialties, Cameroon , Kingue, Samuel University of Yaoundé I - Faculty of Medicine and biomedical sciences - Department of Medicine and clinical specialties, Cameroun

Parathyroid Hormone and 25(OH) Vitamin D Levels in Cameroonian Patients with Chronic Kidney Disease: A Comparison of Patients with and Without Diabetes

20283

Background: Chronic kidney disease (CKD) patients with diabetes show lower levels of 25-hydoxyvitamin D3 (25(OH)D) and parathormone (PTH) compared to nondiabetics in temperate climates. Our aim was to investigate if this association exists in CKD populations in tropical climates. Methods: This cross-sectional study compared fasting serum levels of 25(OH)D and intact PTH in unselected patients with and without diabetes treated for CKD stages 3-5D in 3 nephrology facilities in Cameroon from January-March 2013. Stepwise multinomial logistic regression analysis was used to determine factors associated with 25(OH)D deficiency in nondialyzed patients. Statistical significance was set at a P value≤0.05 Results: Of 112 patients, 45 were diabetics (24 dialyzed) and 67 non-diabetics (51 dialyzed). Diabetics were older (p 0.001), had higher BMIs (p =0.004), more males (p=0.042); received less phosphate binders (p=0.031) and more oral vitamin D3(p=0.007). Mean dialysis vintage was 39±35.6 months (n=75). Mean serum calcium, phosphorus and albumin were 9.5±0.9mg/dl, 4.7±0.23mg/dl and 3.8±0.6mg/dl respectively and comparable in the 2 groups. Diabetics had significantly lower median (25th-75th percentiles) PTH [234(124-405) vs. 475(219-970)pg/ml p=0.021] and 25(OH)D levels [20.2(10.4-32.8) vs. 28.4(20.8-42.6)ng/ml p=0.031]. Vitamin D deficiency (25(OH)D≤15ng/ml) was more prevalent in diabetics (40.0% vs. 14.9%, p=0.003), and this was independently associated with vitamin D deficiency in non-dialyzed patients (OR =7.51, 95%CI 1.71-33.3, p=0.007). Conclusion: Our findings confirm reports from temperate zones and suggest a need for regular monitoring of PTH and 25(OH)D levels especially in non-dialyzed diabetics with CKD in tropical regions.

1

Parathormone , 25(OH)D , vitamin D deficiencydiabetes , CKD

Health Sciences an‎d Diseases

6