Vitamin D deficiency is more prevalent in hemodialysis patients than in pre-dialysis patients with CKD and is associated with decreased dietary intake of Vitamin D. Dialysis restrictions imposed to reduce dietary phosphorus intake likely contributes to the development of hypovitaminosis D in ESRD patients. The avoidance of dairy products (milk, yogurt, and cheese) was as per the dialysis unit dietician recommendations, as these foods are also high in phosphorus. The high prevalence of Vitamin D deficiency in hemodialysis patients and low intake of Vitamin D containing foods (which are also high in phosphates) suggested the possibility that initiating hemodialysis results in lower serum Vitamin D, in part because of imposed dietary restrictions to limit phosphate intake. Vitamin D deficiency is associated with increased morbidity and decreased survival in patients with CKD and ESRD. The etiologies of hypovitaminosis D in the ESRD population are not clear, but include limited sunlight exposure, reduced UVB-induced Vitamin D synthesis in the skin, and disturbed Vitamin D metabolism. In the United States, a significant source of Vitamin D is the consumption of Vitamin D fortified foods, in particular dairy products. Whether the physician/nutritionist imposed, phosphorus-restricted, renal diet impacts serum Vitamin D levels hemodialysis patients has not been studied.
Last date updated on January, 2021