Related Experiment Video

Updated: May 22, 2025

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
10:46

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

Published on: December 9, 2015

10.6K

Assessment of Vitamin D Metabolism Disorders in Hemodialysis Patients

Maksymilian Hryciuk1, Zbigniew Heleniak1, Sylwia Małgorzewicz1,2

  • 1Department of Nephrology, Medical University of Gdańsk, Dębinki 7 Street, 80-211 Gdańsk, Poland.

Nutrients
|March 13, 2025
PubMed

Insights

Patients on hemodialysis have lower vitamin D3 reserves and impaired metabolism. The vitamin D metabolism ratio (VMR) is a sensitive indicator of deficiency, and 24,25(OH)2D3 levels are crucial for assessment.

Area of Science:

  • Endocrinology
  • Nephrology
  • Nutritional Science

Background:

  • End-stage chronic diseases, particularly hemodialysis (HD), are linked to mineral bone disease (MBD), characterized by hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone (PTH).
  • Vitamin D metabolism disorders are prevalent in HD patients, stemming from reduced conversion of 25(OH)D3 to its active form, 1,25(OH)2D3, and impaired inactivation to 24,25(OH)2D3.

Purpose of the Study:

  • To evaluate vitamin D metabolite levels, including 25(OH)D2, 25(OH)D3, 24,25(OH)2D3, and 3-epi-25(OH)D3, in patients undergoing maintenance hemodialysis.
  • To assess the vitamin D metabolism ratio (VMR) as a marker for vitamin D deficiency in HD patients.
  • To compare these levels with a control group of adults without chronic kidney disease (CKD).

Main Methods:

  • A cross-sectional study involving 66 patients on maintenance hemodialysis (HD) and 206 healthy adult controls.
  • Exclusion of participants receiving cholecalciferol supplementation to ensure accurate baseline metabolite measurements.
  • Measurement of various vitamin D metabolites and calculation of the vitamin D metabolism ratio (VMR).

Main Results:

  • Hemodialysis patients exhibited significantly lower 25(OH)D3 levels (15 ng/mL vs. 22 ng/mL) and higher deficiency rates (69% vs. 39%) compared to controls.
  • HD patients showed reduced levels of 24,25(OH)2D3 (0.1 ng/mL vs. 2.1 ng/mL) and a lower VMR (0.9% vs. 9%), indicating impaired vitamin D catabolism.
  • Alphacalcidol supplementation effectively increased 1,25(OH)2D3 levels without altering other vitamin D metabolites, while 25(OH)D2 levels were higher in HD patients.

Conclusions:

  • Hemodialysis patients possess diminished vitamin D3 reserves and exhibit both functional vitamin D deficiency and impaired vitamin D3 catabolism compared to the general population.
  • The vitamin D metabolism ratio (VMR), which incorporates 24,25(OH)2D3 measurements, is a highly sensitive indicator for assessing vitamin D3 deficiency.
  • Alphacalcidol supplementation is effective in raising active vitamin D levels, and 25(OH)D2 is the sole metabolite found at higher concentrations in HD patients.
Abstract

Keywords:
1,25(OH)2D324,25(OH)2D325(OH)D225(OH)D33-epi-25(OH)D3alphacalcidiolchronic kidney diseasehemodialysisvitamin Dvitamin D metabolite ratio

More Related Videos

Assessment of Vascular Function in Patients With Chronic Kidney Disease08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.2K
Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis04:36

Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis

Published on: October 2, 2020

2.1K

Related Concept Videos

Role of Skin in Vitamin D Synthesis01:23

Role of Skin in Vitamin D Synthesis

The skin plays a crucial role in the synthesis of vitamin D, a vital nutrient for various physiological processes in the body. Vitamin D is unique because it can be synthesized in the skin through a series of chemical reactions triggered by exposure to ultraviolet B (UVB) radiation from sunlight.
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin...
4.9K
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
52
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
46
Role of Vitamins in Maintaining Bone Health01:25

Role of Vitamins in Maintaining Bone Health

The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
3.1K
Dialysis01:27

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
246
Skeleton and Calcium Homeostasis01:21

Skeleton and Calcium Homeostasis

Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
4.3K