Vitamin D Deficiency and Diastolic Dysfunction in Chronic Hemodialysis

Abstract

Introduction : Vitamin D deficiency is common and may contribute to increased cardiovascular risk. Cardiovascular complications are the main cause of mortality and morbidity in chronic haemodialysis patients. The aim of this study was to determine the frequency of vitamin D deficiency and its association with left ventricular diastolic dysfunction in chronic haemodialysis patients. Material and Methods : This was a descriptive cross-sectional study conducted over a 3-month period from 15 November 2021 to 14 February 2022 in the Donka National Haemodialysis Centre. Results : Out of a total of 247 haemodialysis patients, cardiac Doppler ultrasonography was performed in 100 patients, with only 21 (8.50%) patients presenting with diastolic dysfunction associated with vitamin D deficiency. The mean age was 43.40 ± 13 years, with extremes of 18 and 68 years. Males predominated in 16 cases (53%). The main cardiovascular risk factors were hypertension and sedentary lifestyle, with proportions of 73.3% and 33.3% respectively. The majority of patients were in group 1 with a deficiency of between (8 - 29 ng/ml), and there was a statistically significant relationship (p = 0.065) between the stage of diastolic dysfunction and vitamin D deficiency. Conclusion: Cardiovascular complications are the main cause of mortality and morbidity in chronic haemodialysis patients. 25-hydroxy-vit D (25OHvit D) deficiency is common in dialysis patients. This deficiency is implicated not only in mineral-bone disorders but also in the worsening of diastolic dysfunction. Only 21 (8.50%) patients had diastolic dysfunction associated with vitamin D deficiency. Studies including large sample size and potential confounding factors such as diet, duration of dialysis and seasonal variations in vitamin D synthesis could provide the most accurate possible answer to this question of cardiovascular morbidity and mortality in chronic haemodialysis patients.