Association between vitamin D deficiency and anemia in patients with end-stage renal disease

Abstract

Background

Despite new treatment strategies, anemia remains the most prevalent complication in patients with end-stage renal disease. We investigated whether 25-hydroxyvitamin D deficiency is associated with anemia in end-stage renal disease patients.

Methods

We reviewed the medical records of 410 end-stage renal disease patients who had undergone renal transplantation at Yonsei University Health System, who had 25-hydroxyvitamin D levels measured at renal transplantation. Patients were divided into group 1 (25-hydroxyvitamin D levels < 10 ng/ml) and group 2 (25-hydroxyvitamin D levels ≥ 10 ng/ml).

Results

Multivariate linear regression analysis indicated an independent association between serum 25-hydroxyvitamin D and hemoglobin levels, after adjusting age, sex, logarithm (base 10) intact parathyroid hormone, phosphate, alkaline phosphatase, logarithm (base 10) high-sensitivity C-reactive protein, ferritin levels, and erythrocyte-stimulating agent dose (β = 0.035; p = 0.039). Odds ratio for developing anemia (hemoglobin level < 10 g/dl) showed that group 1 had a higher risk (Odds ratio = 3.283; confidence interval, 1.040-10.362; p = 0.043) for anemia than group 2, after adjusting for age, sex, log intact parathyroid hormone, phosphate, alkaline phosphatase, logarithm (base 10) high-sensitivity C-reactive protein, ferritin levels, and erythrocyte-stimulating agent use.

Conclusion

25-hydroxyvitamin D deficiency significantly associated with anemia in patients with end-stage renal disease patients. Randomized controlled trials are needed to determine if vitamin D supplementation can improve anemia in these patients.