Vitamin D deficiency and secondary hyperparathyroidism among patients with chronic kidney disease.

BACKGROUND

Chronic kidney disease (CKD) is associated with morbid complications that lead to high mortality and costs. Vitamin D deficiency and secondary hyperparathyroidism (SHPT) are frequent complications of CKD.

METHODS

We reviewed the current literature regarding the prevalence, diagnosis, complications, and management of vitamin D deficiency and SHPT among patients with CKD.

RESULTS

There is a high prevalence of vitamin D deficiency among adolescents and adults in the United States (age and gender dependent). Patients with CKD or those who are dialysis-dependent are much more likely to have low levels of vitamin D in comparison to those without kidney disease. In order to avoid significant complications including SHPT and musculoskelatal diseases, vitamin D needs to be measured routinely by primary care physicians and nephrologists. In the majority of CKD patients, SHPT is not diagnosed until late, leading to advanced cardiovascular and bone diseases.

CONCLUSIONS

In conclusion, current management of vitamin D deficiency and SHPT is suboptimal. Early diagnosis of vitamin D deficiency and SHPT are integral to optimal management of CKD, and additional research is needed in this area.