EVALUATION OF VITAMIN D RECEPTOR LEVEL IN HEMATOPOETIC CELLS AND INFLAMMATORY MARKERS IN STAGE 3-5 CHRONIC RENAL PATIENTS

Abstract

ABSTRACT: In this study, we aimed to compare the relationship of vitamin D replacement with the percentage of vitaminD receptor (VDR) in CD3+, CD4+, CD8+ and CD14+ hematopoietic cells and inflammatory markers in stage 3-5 CKD patients. METHOD: In this prospective study, 81 stage 3-5 CKD patients with estimated glomerular filtration rate (eGFR)≤60ml/min/1.73m2 were included. Serum creatinine, eGFR, intact parathormone (iPTH), 25 OH Vitamin D3 levels, CRP, neutrophil, lymphocyte values and VDR percentages in CD3+,CD4+,CD8+,CD14+ hematopoietic cells were calculated. Patients were divided into groups with a diagnosis of Vitamin D deficiency (<20and≥20 ng/dl) according to 25 OH Vitamin D3 levels, according to CKD stages (stages 3,4 and 5) and according to their vitamin D use status (not using,using calcitriol or 25 OH vitamin D). RESULTS: A statistically significant difference was found between active vitaminD use, creatinine, eGFR and iPTH levels in patients who were divided groups for vitamin D deficiency (p:0.04, p:0.008, p:0.02, p:0.002). There was no statistical difference between CRP and neutrophil/lymphocyte ratio (p:0.95, p:0.63). When we grouped the patients according to CKD stages, a statistical difference was found in iPTH levels (p:0.001). When we divided the patients according to their use of 25 OH vitamin D, a statistical difference was found between creatinine, eGFR, iPTH and 25 OH vitamin D3 levels (p:0.00, p:0.00, p: 0.02 and p:0.006). There was no difference between the percentages of VDR in CD3+, CD4+, CD8+, CD14+ hematopoietic cells (p:0.17, p:0.15, p:0.14, p:0.31). RESULTS: It may be due to the fact that VDR percentages can be kept at similar rates in all stages with Vitamin D replacement therapies and a decrease in inflammation may be achieved. KEYWORDS: Chronic Kidney Disease, Inflamation, Vitamin D, Vitamin D Receptor Level

Keywords

• Chronic Kidney Disease
• Inflamation
• Vitamin D
• Vitamin D Receptor Level

EVRE 3-5 KRONİK BÖBREK HASTALARINDA HEMATOPOETİK HÜCRELERDEKİ VİTAMİN D RESEPTÖR DÜZEYİ İLE İNFLAMASYON BELİRTEÇLERİNİN DEĞERLENDİRİLMESİ

Abstract

ÖZ: Amaç: Bu çalışmada, evre 3-5 Kronik böbrek hastalarında (KBH) vitamin D replasmanının CD3+, CD4+, CD8+ ve CD14+ hematopoietik hücre alt gruplarındaki vitamin D reseptör (VDR) yüzdesi ile inflamatuar belirteçlerle ilişkisini değerlendirmeyi amaçladık. Yöntem: Bu prospektif çalışmada evre 3-5 KBH’sı olan; tahmini glomerüler filtrasyon hızı (tGFH) ≤60ml/dk/1,73m2 olan 81 hasta katıldı. Serum kreatinin, tGFH, intakt parathormon (iPTH), 25 OH vitamin D düzeyleri, CRP, nötrofil, lenfosit değerleri ve CD3+, CD4+, CD8+, CD14+ hematopoietik hücrelerde VDR yüzdeleri hesaplandı. Hastalar, 25 OH VD3 düzeylerine göre Vitamin D eksikliği tanısıyla (<20 ve ≥20 ng/dl) iki gruba, KBH evrelerine göre (evre 3-5) üç gruba, D vitamini kullanımı durumuna göre (kullanmıyor, kalsitriol veya 25 OH vitamin D) üç gruba ayrıldı. Bulgular: Vitamin D eksikliği tanısıyla iki gruba ayrılan hastalarda aktif D vitamini kullanımı, kreatinin, tGFH ve iPTH düzeyleri arasında istatistiksel anlamda fark tespit edildi (p:0,04, p:0,008, p:0,02 ve p:0,002). CRP ve nötrofil /lenfosit oranı arasında istatistiksel fark tespit edilmedi (p:0,95, p:0,63). Hastaları KBH evrelerine göre gruplandırdığımızda iPTH düzeylerinde istatistiksel fark tespit edildi (p:0,001). Hastaları D vitamini kullanımı durumuna göre üç gruba ayırdığımızda kreatinin, tGFH, iPTH ve 25 OH vitamin D3 düzeyleri arasında istatistiksel fark tespit edildi (p:0,00, p:0,00, p: 0,02 ve p:0,006). CD3 +, CD4 +, CD8 +, CD14 + hematopoietik hücrelerde VDR yüzdeleri arasında bir fark tespit edilmedi (p:0,17, p:0,15, p:0,14, p:0,31). Lenfosit düzeyleriyle tGFH değerleri arasında istatistiksel bir korelasyon vardı (r:0,28, p:0,011). Lenfosit düzeyleriyle CD8+ hücrelerin VDR yüzdesi değerleri arasında istatistiksel bir korelasyon vardı (r:0,224, p:0,046). Sonuç: Replasman tedavileri ile VDR yüzdelerinin tüm evrelerde benzer oranlarda tutulabileceği, inflamasyonda azalma sağlanmış olabileceğinden kaynaklı olabilir. ANAHTAR KELİMELER: İnflamasyon, Kronik Böbrek Hastalığı, Vitamin D, Vitamin D Reseptör Düzeyi

Keywords

• İnflamasyon
• Kronik Böbrek Hastalığı
• Vitamin D
• Vitamin D Reseptör Düzeyi

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