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Exploring the relationship between serum vitamin D and atherosclerosis in hemodialysis patients: a cross-sectional

Ashraf Hassan Abd El Mobdy1, Saeed Abdelwahab Saeed1, Walid Ahmed Bichari1

  • 1Internal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Frontiers in Nephrology
|June 26, 2026
PubMed

Insights

This study found no direct link between vitamin D levels and subclinical atherosclerosis in hemodialysis patients. However, serum calcium levels were associated with atherosclerosis, suggesting a potential indirect relationship.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Endocrinology

Background:

  • Subclinical atherosclerosis is a common complication in patients with end-stage renal disease (ESRD) undergoing hemodialysis.
  • Vitamin D deficiency is prevalent in ESRD patients and may influence cardiovascular health.
  • The relationship between vitamin D levels and atherosclerosis in this population requires further investigation.

Purpose of the Study:

  • To investigate the association between serum vitamin D levels and subclinical atherosclerosis, measured by carotid intima-media thickness (CIMT).
  • To explore potential correlations between vitamin D, calcium, lipid profiles, and inflammatory markers in hemodialysis patients.

Main Methods:

  • A cross-sectional study included 90 ESRD patients on hemodialysis, categorized by CIMT (normal vs. increased).
  • Clinical data, serum vitamin D, calcium, lipid profiles, and inflammatory markers were assessed.
  • Carotid ultrasound was used to measure CIMT; statistical analyses included t-tests and Chi-square/Fisher's exact tests.

Main Results:

  • Serum vitamin D showed positive correlations with calcium and triglycerides, and negative correlations with weight, alkaline phosphatase, and urea.
  • No significant differences in demographics, BMI, hemodialysis duration, diabetes, or vitamin D supplementation were found between groups.
  • Elevated serum calcium levels were observed in patients with increased CIMT (p = 0.008).
  • Weight was identified as an independent predictor of low vitamin D levels (p = 0.016).

Conclusions:

  • Serum calcium levels were significantly associated with subclinical atherosclerosis (CIMT).
  • No direct correlation was found between vitamin D levels and CIMT in this cohort.
  • The findings suggest serum calcium, rather than vitamin D, may be more directly linked to atherosclerosis in hemodialysis patients.
Abstract

Keywords:
atherosclerosiscarotid intima-media thicknessend-stage renal diseasemaintenance hemodialysisvitamin D

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