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  • Title: Vitamin D binding protein and the need for vitamin D in hemodialysis patients.
    Author: Speeckaert MM, Glorieux GL, Vanholder R, Van Biesen W, Taes YE, Clement F, Wehlou C, Delanghe JR.
    Journal: J Ren Nutr; 2008 Sep; 18(5):400-7. PubMed ID: 18721734.
    Abstract:
    OBJECTIVE: Vitamin D binding protein (DBP) is a polymorphic serum protein with a predominant role in a spectrum of biological activities. Chronic renal failure is characterized by deficient vitamin D metabolism. The present study investigates the impact of DBP polymorphism on the need for vitamin D in hemodialysis patients. DESIGN: This was a retrospective study. SETTING: This study included hemodialysis patients from the Renal Unit of Ghent University Hospital (Ghent, Belgium) and the Algemeen Stedelijk Ziekenhuis Geraardsbergen Hospital (Geraardsbergen, Belgium). METHODS: One hundred and ninety-one hemodialysis patients and 211 healthy subjects were recruited from the hemodialysis database. The DBP phenotypes were determined by polyacrylamide gel electrophoresis. Serum DBP, parathyroid hormone, 25-hydroxyvitamin D(3), 1,25-dihydroxyvitamin D(3), calcium, albumin, and phosphate were measured. Information regarding the intake of vitamin D analogues was collected. RESULTS: The phenotypic distributions of DBP were in agreement with Hardy-Weinberg equilibrium. Comparing allele frequencies of the two groups, there was an increased proportion of the DBP 2 allele in hemodialysis patients (P < .05). The median serum DBP concentration was lowest in the DBP 2-2 group. The need for oral vitamin D differed significantly (P < .01) between DBP phenotypes, and was greatest in DBP 2-2. CONCLUSIONS: The present study demonstrates an altered DBP allele frequency in hemodialysis patients, compared with the general population. More importantly, vitamin D intake differs depending on the DBP polymorphism, and is greatest for end-stage renal disease patients with a DBP 2-2 phenotype. Therefore, vitamin D treatment deserves more careful monitoring among DBP 2-2 patients with end-stage renal disease.
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