The Relevance Between The Levels Of 25（OH） D₃ And Chronic Kidney Disease Patients Staged 3 5 With Respiratory Tract Infection

Objective:1 To analysis the correlation between the lack of the levels of serum 25(OH) D3 and chronic kidney disease(CKD) patients with acute respiratory infection by detecting its levels.2 To investigate the effects of the vitamin D receptor agonist on reducing the incidence of acute respiratory tract infection in patients with chronic kidney disease.Methods:Selected 60 nondialysis patients with CKD3~ 5 aging from 40 to 80 hospitalized in kidney internal medicine ward during January 2014 to December 2014. Selection criteria: glomerular filtration rate is based on the determined CKD stage.The levels of serum Ca, P, PTH maintain in the normal range recommended by KDOQI and KDIGO.The diagnosis of respiratory tract infection with reference to the Ministry of health issued by the hospital infection diagnosis standard(Trial) in 2001.Recorded the application of vitamin agonists(calcitriol) and dose size,and the situation of hospital for respiratory tract infections in the researchers. Detected the levels of serum hemoglobin, albumin, creatinine, urea nitrogen, calcium, phosphorus, 25 hydroxy vitamin D3, parathyroid hormone on the hospitalized day or the next day.Divided those objects into two groups according to the presence of respiratory infection, one group of 29 cases of infection was the infection group, the non-infection group was 31 cases.All the data entry using Excel for establishing the database, and process using medical statistics software SPSS13.0. The data of the two groups are compared by T test or chi-square test, P < 0.05 for the difference is statistically significant.Results:1 The two groups Whose age, Hb, Alb, Cr, BUN, Ca, P, Ca * P, PTH had no statistically significant(P > 0.05),whose serum 25(OH) D3 was statistically significant(P < 0.05).2 The situation of oral vitamin D in the two groups was statistically significant(P<0.05), which can be thought that oral vitamin D had a therapeutic effect on patients with chronic kidney disease suffered from pulmonary infection.3 The two groups in age, diabetic nephropathy, situation of oral VDRA were statistically significant(P<0.05), suggesting that there is a relationship between respiratory infection in chronic kidney disease(CKD) patients with age, diabetes kidney disease, and whether oral VDRA.While,the age over 60 year-old patients suffering from the risk of respiratory infection is 1.568 times than low 60 year-old ones.The risk of respiratory tract infections in patients with diabetic nephropathy is as 1.680 times as the non-diabetic nephropathy patients.The risk of not taking VDRA in CKD patients suffering from respiratory tract infection is 1.924 times the oral VDRA persons. 4 The ROC curve analysis showed that cutoff point which the evaluation 25(OH) D3 effecting the onset of respiratory tract infection in patients with chronic kidney disease(CKD)is at 27.5 nmol/l.Conclusion:The levels of vitamin D in patients with chronic kidney disease(CKD) is generally lack and deficient.The lack of the serum 25(OH) D3 is associated with chronic kidney disease patients complicating with acute respiratory infection. Chronic kidney disease patients with respiratory tract infection have correlation with age, diabetic nephropathy, and oral vitamin D receptor agonist. Patients with chronic kidney disease(CKD) who taking vitamin D receptor agonists can reduce the incidence of respiratory tract infection.