VITAMIN D DEFICIENCY IS ASSOCIATED WITH SEVERE ACUTE KIDNEY INJURY: A CROSS-SECTIONAL STUDY FROM PESHAWAR, PAKISTAN

Abstract

Background: Acute Kidney Injury (AKI) is a critical medical condition associated with significant morbidity and mortality. Understanding its relationship with Vitamin D may provide insights into potential biomarkers and therapeutic targets.

Objective: To evaluate the association between AKI severity and vitamin D levels in patients from Peshawar, Pakistan.

Methods: This cross-sectional study was conducted at Lady Reading Hospital, Peshawar. Serum 25-hydroxyvitamin D was measured by electrochemiluminescence immunoassay, and serum creatinine by spectrophotometric techniques. Demographic and clinical data were collected through a structured questionnaire. Statistical analysis included one-way ANOVA, Pearson correlation, and binary logistic regression. A p-value <0.05 was considered statistically significant.

Results: The mean age was 45.67 ± 16.45 years with male predominance (61.4%). Mean vitamin D level was 24.78 ± 8.23 ng/mL, and mean creatinine was 3.89 ± 1.45 mg/dL. Vitamin D levels decreased progressively with AKI severity: mild AKI (31.42 ± 7.84 ng/mL), moderate AKI (25.67 ± 6.91 ng/mL), severe AKI (22.34 ± 5.67 ng/mL), and very severe AKI (19.76 ± 8.23 ng/mL) (F = 12.456, p < 0.001). Pearson correlation showed a significant negative correlation between vitamin D and creatinine (r = -0.445, p < 0.001). Vitamin D deficiency (<20 ng/mL) was the strongest independent risk factor for severe AKI (creatinine >5 mg/dL) (OR = 7.07, 95% CI: 2.83-17.65, p < 0.001).

Conclusion: There is a strong inverse association between vitamin D levels and AKI severity. Vitamin D deficiency confers a 7-fold increased risk of severe AKI, highlighting its potential as a prognostic marker and therapeutic target.