Perirenal fat differs in patients with chronic kidney disease receiving different vitamin D-based treatments: a preliminary study

An observational study was performed at UNIRENAL Center (Venezuela), from January to November 2015. Analytical and clinical parameters were evaluated. The PAT thickness was measured in centimeters through a B-mode ultrasound. Thus, we included 83 CKD patients treated with vitamin D or analogs (mean age 58.3 ± 16y); 57.83% were females. Nearly half of the sample was classified as CKD-G3 (n = 40). Prior history of CVD was present in 55.4% (N = 46) of participants. Must of the patients (n = 46;55.42%) receiving oral cholecalciferol (1000 IU/day) as part of the treatment for lower levels of vitamin D or BMD related to CKD (mainly elevated PTH), followed by those under calcitriol at 0.5 mcg/day (n = 27;32.53%), and around 12% (n = 10;12.05%) on paricalcitol (1 mcg/day). The mean treatment vintage was 20 ± 6 months for cholecalciferol, 18 ± 4 months for calcitriol, and 16 ± 2 months for paricalcitol. Those with a history of CVD (n = 46) showed higher levels of urea (mean 62.0vs45.2 mg/dl, p < 0.05), uric acid (mean 5.5vs4.3 mg/dl; p < 0.03), and iPTH (mean 186.2vs65.2pcg/dl; p < 0.05) than patients free of CVD events (n = 37). These findings were also in parallel with decreased renal function in the group with previous CVD history, as evidenced by a significantly lower eGFR (mean 53.55vs89.00 ml/min/1.73 m²,p < 0.001). Similarly, the mean PAT thickness was elevated in the group with a history of CVD in relation to those with no previous CVD events (0.99vs0.80 cm; SD ± 0.30;p ~ 0.05). The comparative analysis for the patients with prior cardiovascular events between the three treatments revealed that those on paricalcitol had lesser PAT accumulation than those treated with cholecalciferol or calcitriol (p < 0.05). In conclusion, our study shows that PAT thickness in CKD may be influenced by vitamin D analog-based treatment. Further research is needed to better understand the mechanistic links between PAT, BMD, and CVD in this population.