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Chronic kidney disease is a main confounding factor for 25-vitamin D measurement

BACKGROUND: Current guidelines recommend assessment of 25-vitamin D status in patients with chronic kidney disease (CKD). Although significant differences among assays have been described, the impact of CKD on this variability has never been tested. METHODS: We tested the variability between two 25-...

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Autores principales: Machado, Hanna Karla Andrade Guapyassú, Martins, Carolina Steller Wagner, Jorgetti, Vanda, Elias, Rosilene Motta, Moysés, Rosa Maria Affonso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Nefrologia 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213929/
https://www.ncbi.nlm.nih.gov/pubmed/31769778
http://dx.doi.org/10.1590/2175-8239-JBN-2019-0053
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author Machado, Hanna Karla Andrade Guapyassú
Martins, Carolina Steller Wagner
Jorgetti, Vanda
Elias, Rosilene Motta
Moysés, Rosa Maria Affonso
author_facet Machado, Hanna Karla Andrade Guapyassú
Martins, Carolina Steller Wagner
Jorgetti, Vanda
Elias, Rosilene Motta
Moysés, Rosa Maria Affonso
author_sort Machado, Hanna Karla Andrade Guapyassú
collection PubMed
description BACKGROUND: Current guidelines recommend assessment of 25-vitamin D status in patients with chronic kidney disease (CKD). Although significant differences among assays have been described, the impact of CKD on this variability has never been tested. METHODS: We tested the variability between two 25-vitamin D assays in patients with CKD (eGFR < 60 mL/min/1.73m(2)) who had consecutive 25-vitamin D measurements in 2015 (Assay 1 - Diasorin LIASON 25 TOTAL - D assay(®)) and 2016 (Assay 2 - Beckman Coulter Unicel Xl 800(®)). The cohort consisted of 791 adult patients (122 with normal renal function and 669 with CKD - 33, 30, and 37% in stages 3, 4, and 5 on dialysis, respectively). RESULTS: Levels of 25-vitamin D were lower and the prevalence of hypovitaminosis D using assay 1 was higher than using assay 2 in patients with CKD, regardless of similar levels of calcium, phosphate, and parathyroid hormone. As kidney function decreased, the percentage of disagreement between the assays increased. CONCLUSION: There is a noteworthy variability between assays in patients with CKD such that the diagnosis of hypovitaminosis D is modified. The mechanism behind this result is still unclear and might be due to a possible interference in the analytical process. However, the clinical significance is unquestionable, as the supplementation of vitamin D can be erroneously prescribed to these patients.
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spelling pubmed-72139292020-05-13 Chronic kidney disease is a main confounding factor for 25-vitamin D measurement Machado, Hanna Karla Andrade Guapyassú Martins, Carolina Steller Wagner Jorgetti, Vanda Elias, Rosilene Motta Moysés, Rosa Maria Affonso J Bras Nefrol Brief Communications BACKGROUND: Current guidelines recommend assessment of 25-vitamin D status in patients with chronic kidney disease (CKD). Although significant differences among assays have been described, the impact of CKD on this variability has never been tested. METHODS: We tested the variability between two 25-vitamin D assays in patients with CKD (eGFR < 60 mL/min/1.73m(2)) who had consecutive 25-vitamin D measurements in 2015 (Assay 1 - Diasorin LIASON 25 TOTAL - D assay(®)) and 2016 (Assay 2 - Beckman Coulter Unicel Xl 800(®)). The cohort consisted of 791 adult patients (122 with normal renal function and 669 with CKD - 33, 30, and 37% in stages 3, 4, and 5 on dialysis, respectively). RESULTS: Levels of 25-vitamin D were lower and the prevalence of hypovitaminosis D using assay 1 was higher than using assay 2 in patients with CKD, regardless of similar levels of calcium, phosphate, and parathyroid hormone. As kidney function decreased, the percentage of disagreement between the assays increased. CONCLUSION: There is a noteworthy variability between assays in patients with CKD such that the diagnosis of hypovitaminosis D is modified. The mechanism behind this result is still unclear and might be due to a possible interference in the analytical process. However, the clinical significance is unquestionable, as the supplementation of vitamin D can be erroneously prescribed to these patients. Sociedade Brasileira de Nefrologia 2019-09-26 2020 /pmc/articles/PMC7213929/ /pubmed/31769778 http://dx.doi.org/10.1590/2175-8239-JBN-2019-0053 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Brief Communications
Machado, Hanna Karla Andrade Guapyassú
Martins, Carolina Steller Wagner
Jorgetti, Vanda
Elias, Rosilene Motta
Moysés, Rosa Maria Affonso
Chronic kidney disease is a main confounding factor for 25-vitamin D measurement
title Chronic kidney disease is a main confounding factor for 25-vitamin D measurement
title_full Chronic kidney disease is a main confounding factor for 25-vitamin D measurement
title_fullStr Chronic kidney disease is a main confounding factor for 25-vitamin D measurement
title_full_unstemmed Chronic kidney disease is a main confounding factor for 25-vitamin D measurement
title_short Chronic kidney disease is a main confounding factor for 25-vitamin D measurement
title_sort chronic kidney disease is a main confounding factor for 25-vitamin d measurement
topic Brief Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213929/
https://www.ncbi.nlm.nih.gov/pubmed/31769778
http://dx.doi.org/10.1590/2175-8239-JBN-2019-0053
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