Chicken or the egg: Vitamin D deficiency in Chronic Kidney Disease of Uncertain Etiology in Sri Lanka

Background: Vitamin D deficiency is a poorly studied nutritional disorder in CKDu. There are no published studies on vitamin D levels in CKDu; a unique environmental nephropathy in tropical countries. This study was aimed to describe the prevalence of vitamin D, iron and vitamin B 12 status in CKDu patients and to determine associations between vitamin D status and socio demographic factors, nutritional status and dietary intake of vitamin D. Method This was a cross sectional survey conducted among the CKDu patients in Wilgamuwa area, in Mathale district located in the Central province of Sri Lanka. Data was collected by laboratory evaluation, clinical examination and interviewer administered questionnaire and analyzed using SPSS statistical software. Results Out of the 150 of respondents, 74.0% (n = 111) had vitamin D deficiency, 72.0% (n = 108) had anemia, and 3.3% (n = 5) had vitamin B 12 deficiency, in both genders. There was no significant difference in the prevalence of anemia, low serum ferritin and vitamin B 12 deficiency between males and females. Gender was significantly associated with the vitamin D deficiency (p<0.05). Females were 7.69 times more likely to have vitamin D deficiency compared to males. Vitamin D deficiency was 1.7 times higher among those who received social welfare benefits than those who did not receive it. High intake of fish was protective against vitamin D deficiency. Conclusion Isolated Vitamin D deficiency was the most prevalent nutritional deficiency among CKDu patients of Sri Lanka. Correction of these deficiencies may have a favorable effect on CKDu outcome.