Abstract

Objective: To determine the mean decrease in spot urinary protein to creatinine ratio after cholecalciferol (vitamin D3) replacement, in CKD III-IV patients with vitamin D deficiency/ insufficiency.

Methodology: This Quasi experimental study was conducted at Nephrology Department at Fatima Memorial Hospital, Lahore. We enrolled 100 cases with age range 18-70 yrs in both gender and those with CKD stage III and IV, and Vitamin D insufficiency and deficiancy. All cases with Vitamin D deficiency/ insufficiency were supplemented with cholecalciferol. Baseline levels of 25(OH) D, serum creatinine, urinary protein and creatinine (single spot urinary sample taken between 08-11 a.m.) was taken and later measured every two months, for a total period of six months.

Results: In our study, mean age was 49.81+13.10 years, 61%(n=61) were male and 39%(n=39) were females, 83%(n=83) had class III and 17%(n=17) had class IV, 79%(n=79) had vitamin D deficiency while 21%(n=21) had insufficiency, mean pre treatment creatinine values were calculated as 2.13+0.75 while 1.66+0.74 in post treatment period, p value was calculated as 0.0001, mean pre treatment protein to creatinine ratio was 1.97+0.34 while 0.46+0.10 in post treatment period, p value was calculated as 0.000, mean decrease in pre and post treatment serum creatinine level was recorded as 0.46+0.01, mean decrease in pre and post treatment serum protein to creatinine level was recorded as 1.51+0.28.

Conclusion: We concluded that a significant mean decrease in spot urinary protein to creatinine ratio after cholecalciferol (vitamin D3) replacement was recorded in CKD III-IV patients with vitamin D deficiency/ insufficiency but our reuslts are primary and multicenter trials are required to validate our findings.

Keywords: Chronic kidney disease, vitamin D deficiency/insufficiency, cholecalciferol, spot urinary protein to creatinine ratio