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| FREE AND TOTAL 1,25-DIHYDROXYVITAMIN-D LEVELS IN SUBJECTS WITH RENAL-DISEASE |
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| Author(s): KOENIG KG, LINDBERG JS, ZERWEKH JE, PADALINO PK, CUSHNER HM, COPLEY JB |
| Source: KIDNEY INTERNATIONAL Volume: 41 Issue: 1 Pages: 161-165 Published: JAN 1992 |
| Times Cited: 32 References: 20 |
| Abstract: Patients with nephrotic syndrome and varying degrees of renal failure, including those on chronic hemo- and peritoneal dialysis, may have low serum concentrations of total 1,25-dihydroxyvitamin D [1,25(OH)2D]. However, it is unknown whether the true activity of 1,25(OH)2D is better reflected by the free 1,25(OH)2D fraction. We measured total 1,25(OH)2D, free 1,25(OH)2D, and vitamin-D-binding protein (DBP) in normal subjects (group A), subjects with moderate renal failure (group B), subjects on hemodialysis (group C), subjects on peritoneal dialysis (group D), and subjects with nephrotic syndrome (group E). The serum concentrations of total and free 1,25(OH)2D decreased with worsening renal function in groups A through C, with a high degree of correlation (r = 0.974, P < 0.0001). Levels of DBP and the percent free 1,25(OH)2D remained constant in these groups. Patients on peritoneal dialysis and nephrotic patients had lower levels of DBP (203 +/- 14-mu-g/ml and 371 +/- 46-mu-g/ml, respectively) than normal subjects (436 +/- 33-mu-g/ml) and had significantly higher percent free 1,25(OH)2D (0.98 +/- 0.13% and 1.27 +/- 0.14%, respectively) compared to 0.63 +/- 0.03% (P < 0.05). Thus, the loss of DBP in these patients correlated with a rise in the percent free 1,25(OH)2D. We conclude that levels of total 1,25(OH)2D are an accurate representation of 1,25(OH)2D status in normal subjects, subjects with renal insufficiency without nephrotic syndrome, and hemodialysis patients. In peritoneal dialysis and nephrotic patients, who lose DBP, measurements of free 1,25(OH)2D may be necessary in order to accurately assess 1,25(OH)2D status. |
| Document Type: Article |
| Language: English |
Addresses:
1. ALTON OCHSNER MED FDN & OCHSNER CLIN, DEPT INTERNAL MED, NEPHROL SECT, 1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121 USA
2. WILLIAM BEAUMONT ARMY MED CTR, DEPT INTERNAL MED, EL PASO, TX 79920 USA
3. MADIGAN ARMY MED CTR, DEPT INTERNAL MED, TACOMA, WA 98431 USA
4. UNIV TEXAS SW, DEPT MINERAL METAB, DALLAS, TX USA |
| Publisher: BLACKWELL SCIENCE INC, 350 MAIN ST, MALDEN, MA 02148 |
| Subject Category: Urology & Nephrology |
| IDS Number: GX918 |
| ISSN: 0085-2538 |
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| | | | | | | | | Record from Web of Science® | | | | | | | | | |