| Objective Observe the serum vitamin A level in patients with chronic kidney disease(CKD)and analyse its correlation with common clinical complications,and provide reference for clinical treatment.Methods 190 patients with chronic kidney disease were admitted to the Department of Nephrology in Affiliated Zhongshan Hospital of Dalian University and 30 healthy controls were enrolled into the study,since October 2016 to May 2017.The subjects were divided into non-dialysis groups: 30 patients(C1)with 1~3 stages of chronic kidney disease,and 30 patients(C2)with stage 4~5 of chronic kidney disease;dialysis group: 30 patients with peritoneal dialysis(PD),100 patients with hemodialysis(HD);healthy control group 30 cases(H).Inclusion criteria:(1)no parathyroidectomy history;(2)Stop taking calcium or active vitamin D for 2 weeks.Inclusion criteria-dialysis group:(1)regular dialysis duration ≥1 year;(2)no parathyroidectomy history;(3)Stop taking calcium or active vitamin D for 2 weeks.Exclusion criteria:(1)the use of vitamin A,calcitonin,bisphosphonates and other drugs within 30 days before enrollment;(2)severe circulatory,digestive,and respiratory system diseases as well as liver diseases,thyroid diseases;(3)history of parathyroidectomy;(4)recent taking glucocorticoids,cytotoxic drugs and other immunosuppressive agents;(5)chronic kidney disease caused by systemic autoimmune diseases such as systemic lupus erythematosus;(6)poor patient compliance and cannot adjust medication based on doctor’s advice.General information such as gender,age,disease duration,and primary disease of the study subjects were collected.All the blood samples were taken in the morning on an empty stomach,and the dialysis group was taken with a venous blood before connecting the dialysis device and using heparin.Serum ALB,SCR,BUN,HGB,and PTH were measured.Serum levels of vitamin A and vitamin D were respectively tested by enzymelinked immunosorbent assay and chemiluminescent immunoassay.All the medical records of the study subjects were built into a database,and all data were analyzed and processed using SPSS 21.0 software.Measured data were expressed as standard mean±deviation().The two sets of measurement data were compared using t-test,and multiple sets of measurement data were analyzed by variance analysis.If the normal distribution can not be used,then the rank sum test was used.The correlation analysis between the two variables used Pearson linear regression analysis.p<0.05 indicated that the difference was significant.Results(1)There was a negative correlation between serum vitamin A with e GFR levels in patients with chronic kidney disease(r=-0.572,p=0.002).Serum vitamin A levels in the H,C1,C2,PD,and HD groups were(30.64±3.75)ug/d L,(33.45±5.43)ug/d L,(48.61±8.64)ug/d L,and(49.61±4.87)ug/d L,(51.13±15.42)ug/d L respectively,the difference in vitamin A levels between each group and H group was significant(p<0.05),and the difference between C2 and C1 group of vitamin A was significant(p=0.001).Vitamin A levels in the HD group were mild higher than those in the PD group,and the difference was not significant(t=-0.990,p=0.324).(2)Pearson correlation analysis indicated there was a negative correlation between vitamin A and vitamin D(r=-0.182,p =0.012),and a positive correlation with hemoglobin(r=0.556,p=0.001)and serum calcium(r=0.254,p=0.000).No correlation with parathyroid hormone(r=0.11,p=0.059)and serum phosphorus(r=0.014,p=0.388).Conclusions(1)In patients with chronic kidney disease,serum vitamin A levels gradually increased with the progress of renal function,and there was no significant difference in serum vitamin A levels between hemodialysis group and peritoneal dialysis group.(2)The level of vitamin A in patients with chronic kidney disease have positive correlation with hemoglobin and serum calcium levels,and negative correlation with vitamin D levels. |
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