The effect of some medications given to CKD patients on vitamin D levels

Abstract Background Vitamin D deficiency and polypharmacy is a common problem over chronic kidney disease (CKD) population. Objectives To assess the clinical and analytical characteristics of CKD patients with 25-OH-D3 deficiency ( Methods A single center observational review of 137 incident patients referred to our outpatient clinic with different stages of CKD and 25-OH-D3 2 ). 25-OH-D3 levels were collected in spring. Clinical and biochemical data and associated medications were recorded. Results Mean 25-OH-D3 levels were 8.23 [±4.03] ng/ml. Eighty-eight patients (64.7%) had 3 or more concomitant drugs. Only 7 patients (5.1%) were not receiving any medication. Patients were divided in three groups according the therapies into none (n=26), RAS inhibitors or allopurinol (n=81), and RAS inhibitors plus allopurinol (n=30); with the aim to study the influence of statin therapy. Patients under renin angiotensin (RAS) inhibitors or Allopurinol treatment presented significantly higher 25-OH-D3 levels (p=0.001 and p=0.01 respectively), however patients with Statins treatment had lower 25-OH-D3 level (p=0.039). Personal history of diabetes, cardiovascular events or other therapies did not modify 25-OH-D3 levels, adjusted by age and eGFR. Conclusions CKD patients with vitamin D deficiency who received RAS inhibitors or Allopurinol treatment had higher 25-OH-D3 levels, however those with statins treatment had lower vitamin D levels. Randomized controlled trials are required to confirm these findings.