Nephrine Health Online | 85%of this kind of vitamin is lacking.

Vitamin is an indispensable type of nutrients that maintain human health. It plays an important role in regulating body metabolism and maintaining normal physiological functions. People often heard that vitamin A, B, and C, but there is a vitamin, and more than half of people lack. It is vitamin D.

Vitamin D deficiency is a public health problem worldwide. It is estimated that about 30%-50%of children and adults around the world have vitamin D deficiency. In my country, vitamin D is also common. According to a survey in Beijing in 2020, the proportion of healthy adult vitamin D is as high as 85.68%. Among patients with kidney disease, this phenomenon is even more obvious. Most CKD patients have insufficient vitamin D, and almost all secondary thyroid hyperthyroidism (SHPT) patients have insufficient vitamin D.

01

Powerful vitamin D

Vitamin D, also known as sunny vitamins, often thinks that it can supplement calcium, promote intestinal absorption of calcium and phosphorus, help maintain normal bone metabolism, and prevent osteosclerosis and osteoporosis.

In addition, the effect of vitamin D on the human body also includes the effects of muscles, cardiovascular, metabolism, immunity, tumor occurrence, pregnancy and fetal development.

Vitamin D can enhance muscle strength and balance and reduce the risk of falling. The benefits of pregnancy and fetus are manifested in enhancing congenital immunity and reducing adaptive immunity. In addition, vitamin D also has the effects of preventing cardiovascular disease, metabolic diseases, immune diseases, anti -tumor, and anti -infection.

For patients with kidney disease, due to the decline in kidney function, the activity of 1α hydroxylase in the kidney decreases, which leads to a deficiency of active vitamin D. Or a large amount of proteinuria causes 25 (OH) vitamin D binding protein loss, or low protein diet, resulting in insufficient vitamin D intake, which are the reasons why patients with kidney disease lack vitamin D.

At the same time, active vitamin D is decreased, decreased in calcium absorption, decreased blood calcium, and increased resistance to vitamin D can all cause reduced osteopsis, which leads to renal bone disease. Therefore, the decrease in vitamin D is closely related to the progress and prognosis of chronic kidney disease. Full amount of vitamin levels can reduce proteinuria, inhibit inflammatory response, reduce the incidence of cardiovascular disease, infection, and renal anemia in patients with chronic kidney disease. In recent years, our studies have shown that high -vitamin D level can reduce the risk of 39%of patients with long -term dialysis.

02

Which groups are more likely to lack vitamin D?

Elderly

The digestive function of the elderly decreases, and the amount of eating is reduced, which can easily lead to nutrient deficiency; secondly, the ability of skin synthesis vitamin D has decreased.

Pregnant women and breastfeeding women and infants

The demand for vitamin D during pregnant women and lactating women has increased significantly, which can easily lead to the deficiency of vitamin D, the growth and development of infants and young children, and the level of vitamin D is not easy to keep up with the physiological needs of infants and young children.

Police and long -term indoor office crowd in the northern region

This kind of population is related to the daily acceptance of the sun. The lack of vitamin D in the region north of 35 degrees north latitude is more serious. Especially in winter and spring, it is more obvious. Long -term indoor office groups rarely come into contact with the sun, and they are also high -incidence people who lack vitamin D.

Chronic diseases

Patients with gastrointestinal diseases, such as celtic diarrhea, Crohn's disease, etc., their digestive system absorbs obstacles, resulting in insufficient vitamin D intake. Renal and immune diseases require long -term treatment of glucocorticoid treatment, and hormone -related osteoporosis is prone to occur. For people taking antiepileptic drugs, drugs can induce liver granase to change, which reduces the activity of vitamin D25-hydroxylase. Decreased liver and renal dysfunction can also affect vitamin D hydroxy into activity 25- (0H) D and 1,25- (OH) 2D. In addition, obese people are also prone to decline in vitamin D levels, which may be related to the accumulation of a large amount of vitamin D in fat, affecting its biological activity.

03

What are the clinical manifestations of vitamin D?

The symptoms of vitamin D deficiency are not specific and are easily ignored. Infants and young children lack vitamin D prone to irritability, irritability, night shocks, sweating, and children lack vitamin D can cause bone development disorders, such as 佝偻 disease. Adults lack vitamin D prone to muscle weakness, bone pain, decreased endurance, and easy cramps.

04

How to diagnose vitamin D deficiency?

Adults can detect the concentration of 25-hydroxye vitamin D (25 (OH) D).

(1)> 75nmol/L is sufficient vitamin D;

(2) 50 ~ 75nmol/L is insufficient vitamin D;

(3) <50nmol/L is the deficiency of vitamin D;

(4) <25nmol/L is a serious lack of vitamin D.

05

How should vitamin D supplement?

80%~ 90%of vitamin D in the human body comes from its own synthesis, and 10%~ 20%comes from ordinary vitamin D in food. Recommended intake of dietary vitamin D in Chinese residents is 10 μg per day and 15 μg per day for the elderly over 65 years old.

In life, increasing sunshine time and consumption of vitamin D foods are the most effective way to prevent vitamin D lack.

The sun is shining on the skin, and the body will produce vitamin D. This part of vitamin D accounts for 90%of the body's vitamin D. 30 centimeters of hands every day and 30 minutes in the sun can effectively prevent the lack of vitamin D.

Reminder:

Patients with lupus erythematosus should avoid the sun. In addition, appropriate protective measures are taken when the skin is tender, the elderly, and children to avoid damage caused by exposure. Recently, the weather is hot, and the time to control the sun should be controlled to avoid the sun at noon to avoid heat stroke. In daily diet, you can eat foods with rich vitamin D content. Vitamin D content in natural foods is low. Among them, animal food is an important source of natural vitamin D, such Vitamin D. But at the same time, it is important to note that food cholesterol rich in vitamin D is also relatively high, and it is necessary to measure the advantages and disadvantages.

06

Can I take vitamin D supplements?

Vitamin D cannot be supplemented blindly. It is best to do a detection of vitamin D before adding. Excessive amount may cause vitamin D poisoning. Vitamin D poisoning can be manifested as anorexia, constipation, vomiting, headache, thirst and urine, decreased muscle tension, heart rate abnormality, etc., and may even cause hypercalcemia and kidney calcium. If the dose is too large, it may cause renal function Failure.

07

How should patients with chronic kidney disease supplement vitamin D?

Patients with chronic kidney disease should regularly monitor serum 25-hydroxye vitamin D and thyroid glandularity (PTH), blood calcium, and blood phosphorus levels to guide the adjustment dose of vitamin D in accordance with the staging of the disease to guide the adjustment of vitamin D. The D concentration is adjusted to more than 50nmol/L, and the ideal level is above 75nmol/L to prevent vitamin D lack of nephropathy and secondary thyroid hyperthyroidism.

Now it has ushered in the Summer Sanfu Sky. While the weather is good, the sun is bright, go to the sun to supplement vitamin D!

Guide experts:

Liu Xusheng

Chief physician, professor, director of the Department of Nephrology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Discipline Leader, Doctoral Tutor, Postdoctoral Cooperation Professor, head of key diseases (chronic kidney disease) at the National Chinese Medicine Research Base The person in charge of the center, the second batch of old Chinese medicine academic heirs in the country, and the second hundred outstanding youth traditional Chinese medicine in the country.

He is currently the deputy chairman of the kidney disease branch of the Chinese Medicine Society, deputy chairman of the Professional Committee of Kidney Disease Prevention and Control of the Chinese Association of Prevention and Medicine, Deputy Chairman of the Children's Society of Chinese Medicine Society, President of the Nephrology Branch of the Chinese National Medicine Society, China Industry, Scholar Research Research Research The chairman of the Promotion Association of TCM Nephrology Prevention and Control, Chairman of the Commission of Nephrology of the General Society of the Traditional Chinese and Western Medicine Society, and chairman of the Commissioner of the Slow Disease Management Professional Committee of the Guangdong Provincial Society of Traditional Chinese Medicine.

Good at: chronic nephritis, nephropathy syndrome, acute, chronic renal failure, hypertension nephropathy, diabetic nephropathy, lupus nephritis, etc.; Chinese medicine combined with hemodialysis and peritoneal dialysis to treat uremia.

Supply: Jiecina, Nendochoa, University of the University of Traditional Chinese Medicine Hospital, Guangdong Province

Executive editor: Wu Yuan Tuan

Audit school pair: Zhuang Yingge

Editor in charge: Song Liping

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