VITAMIN D STATUS, PARATHYROID HORMONE AND INFLAMMATION IN HEMODIALYSIS PATIENTS

Background: Disorders of mineral and bone metabolism are common in patients with chronic kidney disease especially in hemodialysis patients. It possible that 25-hydroxyvitamin D could play an important role in both inflammation and bone metabolism.

Aim: To analyze and assess the relationship between markers of bone metabolism and those of inflammation in hemodialysis patients.

Methods: A cross-sectional study was conducted in 120 hemodialysis patients and 82 healthy control subjects. Bone metabolism was assessed by measurement of 25-hydroxyvitamin D, parathyroid hormone, calcium and phosphorus using an immunological and biochemical methods. The inflammatory status (pro-inflammatory cytokines and C-reactive protein) was determined using an immunosorbent assay kit (Cayman). Differences between groups were performed using SPSS 20.0 and data were expressed as the mean ± SD.

Results: Compared to control group, we noted a decrease in Vitamin D and calcium in hemodialysis patients. An increase in parathyroid hormone, phosphorus, pro-inflammatory cytokines (Tumor Necrosis Factor-alpha, Interleukin-1beta and Interleukin-6) and in C-reactive protein was noted in hemodialysis patients. We found a negative correlation between levels of Vitamin D and parathyroid hormone. However, parathyroid hormone was negatively correlated with calcium and positively correlated with phosphate. On the other hand, we found a negative correlation between levels of Tumor Necrosis Factor-alpha and Vitamin D. Moreover, level of Tumor Necrosis Factor-alpha was positively correlated with that of parathyroid hormone.

Conclusion: Inflammation causes bone metabolic disturbances and disorders in hemodialysis patients.