Status of Vitamin D, Parathyroid Hormone, and Alfacalcidol among Anemic Hemodialysis Patients with Chronic Kidney Disease in the Gaza Strip
Abstract
Background: Chronic kidney disease (CKD) is a progressive condition commonly associated with disturbances in vitamin D metabolism, secondary hyperparathyroidism, and renal anemia. This study aimed to assess serum vitamin D and parathyroid hormone (PTH) levels in patients with CKD-related anemia undergoing hemodialysis and to evaluate their relevance for biochemical monitoring during alfacalcidol therapy. Methods: A cross-sectional study was conducted between October 2023 and May 2024 and included 300 adult male and female patients with CKD-related anemia undergoing hemodialysis. Blood samples and relevant demographic and clinical data were collected. Serum vitamin D and PTH levels were measured and analyzed according to sex and age group. Vitamin D status was classified as deficient (<10 ng/mL), insufficient (10–30 ng/mL), or sufficient (>30 ng/mL), while elevated PTH was defined as >66.5 pg/mL. Results: The overall mean serum vitamin D level was 20.2 ng/mL, indicating vitamin D insufficiency. Female patients had significantly higher mean vitamin D levels than male patients (21.7 ng/mL; P = 0.040). Male patients represented 56.3% of the study population, while patients aged <55 years accounted for 58.7%. Overall, 67.3% of patients had insufficient vitamin D levels, whereas 10.3% had vitamin D deficiency. Vitamin D insufficiency was reported in 67.0% of patients aged <55 years and 84.6% of those aged ≥55 years. The overall mean PTH level was markedly elevated at 202.2 pg/mL. Elevated PTH levels predominated across all sex and age categories compared with normal or low PTH levels. Conclusion: Vitamin D insufficiency and markedly elevated PTH levels were common among hemodialysis patients with CKD-related anemia. These findings support the importance of routine monitoring of vitamin D and PTH levels in the assessment and management of CKD-related mineral and bone disorders, particularly among patients receiving alfacalcidol therapy.