Abstract Ref Number = APCP730
25-HYDROXYVITAMIN D3 LEVELS IN CHILDREN WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND ITS ASSOCIATION WITH RENAL DISTURBANCE
Aninditya Dwi Messaurina,Sumadiono ,Cahya Dewi Satria,Retno Palupi Baroto
Department of Child Health Faculty of Medicine Public Health and Nursing Universitas Gadjah Mada Dr Sardjito General Hospital Yogyakarta Indonesia Department of Child Health, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Dr Sardjito General Hospital, Yogyakarta Indonesia
Background : Vitamin D deficiency is commonly found in children with Systemic Lupus Erythematosus (SLE) compared to normal individual. Studies showed that vitamin D deficiency contributes to the progression of chronic kidney disease. However, the association between vitamin D levels and renal function in children with lupus has not been well defined. This study aimed to determine association between 25-hydroxyvitamin D3 levels and renal function, analysed from glomerular filtration rate (GFR) in children with SLE.
Material : We conducted a cross sectional study involving 62 pediatric lupus patients in the Department of Child Health, Sardjito Hospital who folllowed the treatment protocol from January 2014 to April 2018. The association between serum levels of 25-hydroxyvitamin D3 and GFR was analysed using univariate and multivariate logistic regression. Vitamin D deficiency was defined as concentration levels of 25-hydroxyvitamin D3<20 ng/ml whereas renal disturbance was defined as GFR <90/ml/mnt/1.73m2.
Results : Most of the subjects assigned for this study was girls (93.5% vs 6.5%) with mean of age 14.6+3.1 years old and Mex-SLEDAI score which assessed the activity of the disease, 7.6+5.6. In total, 66% of participants had vitamin D deficiency. Subjects with vitamin D deficiency had higher risk to develop GFR disturbance than subjects with normal vitamin D levels (OR 5.481; 95%, CI 1.11-26.8). Logistic regression analysis showed a substantial association between vitamin D deficiency and GFR disturbance (36.6% vs 9.5%, p=0.036). Sex, obesity, calcium, steroid, and disease activity were statistically not significant (p>0.05) in its association with GFR.
Conclusions : There was a significant association between 25-hydroxyvitamin D3 levels and renal function in pediatric systematic lupus erythematosus patients.This study provides insight to monitor the levels of vitamin D as a part of routine monitoring for children with lupus. This may prevent the progression of renal disturbance in patients who are at risk.
Keywords: Vitamin D Renal Disturbance Systemic Lupus Erythematosus Children