Vitamin D Levels in Chronic Kidney Disease Stage 3, 4, and 5

David Kristianus, Rudi Supriyadi, Siska Wiramihardja


Background: Hypovitaminosis D is highly prevalent in chronic kidney disease (CKD). This conditionmay increase CKD progression and cause various complications, since kidney has a pivotal role in metabolizing the vitamin D. The aim of this study was to find the difference in vitamin D levels among CKD stage 3 to 5.

Methods: A cross-sectional study involving patients aged over 18 years with CKD stage 3 to 5 who visited Dr. Hasan Sadikin General Hospital, Dustira Hospital, and Kidney Special Hospital Ny. R.A. Habibie in 2017 was conducted. CKD stages were determined based on glomerular filtration rate (GFR). Kruskal-Wallis test was used to analyzethe difference in vitamin D levels among CKD stage 3 to 5.

Results: One hundred subjects consisting of 57 men and 43 women met the study criteria. There were 97% of subjects experienced hypovitaminosis D, with 20% having vitamin D insufficiency and 77% having vitamin D deficiency. In subjects with vitamin D insufficiency, a decrease in the mean vitamin D levels was observed along with advancing stages of CKD (p=0.255). No vitamin D level difference was observed among CKD stage 3 to 5 [11.1 (3.8-27.7) ng/mL vs 14.45 (5.10-50.90) ng/mL vs 11.7 (4.2-38.0) ng/mL, p>0.05].

Conclusions: There is no difference in vitamin D levels among CKD stage 3, 4 and 5.




Chronic kidney disease; deficiency; vitamin D

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Eknoyan G, Lameire N, Eckardt K, Kasiske B, Wheeler D, Levin A, et al. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2013;3(1):1–150.

World Kidney Day. World kidney day: chronic kidney disease. 2018. [cited 2018 August 5]. Available from:

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095–128.

Kementrian Kesehatan Republik Indonesia. Pusat data dan informasi kementrian kesehatan republik indonesia: situasi penyakit ginjal kronis. Jakarta: Kementrian Kesehatan Republik Indonesia; 2017.

Bargman JM, Skorecki K. Chronic Kidney Disease. In: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 19th ed. New York: McGraw-Hill Education; 2015. p. 1811–21.

Kim CS, Kim SW. Vitamin D and chronic kidney disease. Korean J Intern Med. 2014;29(4):416–27.

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30.

Inda Filho AJ, Melamed ML. Vitamin D and kidney disease: what we know and what we do not know. J Bras Nefrol. 2013;35(4):323–31.

Soesanti F, Pulungan A, Tridjaja B, Batubara JR. Vitamin D profile in healthy children aged 7-12 years old in Indonesia. Int J Pediatr Endocrinol. 2013;2013(Suppl 1):P167.

Nigwekar SU, Tamez H, Thadhani RI. Vitamin D and chronic kidney disease-mineral bone disease (CKD-MBD). Bonekey Rep. 2014;3:498–503.

Li YC. Vitamin D in chronic kidney disease. Contrib Nephrol. 2013;180:98–109.

Mac Way F, Lessard M, Lafage-Proust MH. Pathophysiology of chronic kidney disease-mineral and bone disorder. Joint Bone Spine. 2012;79(6):544–9.

Seifert ME, Hruska KA. The kidney-vascular-bone axis in the chronic kidney disease-mineral bone disorder. Transplantation. 2016;100(3):497–505.

Diniz HF, Romao MF, Elias RM, Romao Junior JE. Vitamin D deficiency and insufficiency in patients with chronic kidney disease. J Bras Nefrol. 2012;34(1):58–63.

Rozita M, Afidza MN, Ruslinda M, Cader R, Halim AG, Kong CTN, et al. Serum vitamin D levels in patients with chronic kidney disease. EXCLI J. 2013;12:511–20.

Prakash S, O’Hare AM. Interaction of aging and chronic kidney disease. Semin Nephrol. 2009;29(5):497–503.

Lee K, Lee S, Cho H. Optimal vitamin d levels in children with chronic kidney disease. J Nephrol Ther. 2015;5(4):207–10.

Nimitphong H, Holick MF. Vitamin D status and sun exposure in Southeast Asia. Dermatoendocrinol. 2013;5(1):34–7.

Tsiaras WG, Weinstock MA. Factors influencing vitamin D status. Acta Derm Venereol. 2011;91(2):115–24.

Zheng Z, Shi H, Jia J, Li D, Lin S. Vitamin D supplementation and mortality risk in chronic kidney disease: a meta-analysis of 20 observational studies. BMC Nephrol. 2013;14(1):199–211.


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