A Meaning Of Ozagrel
Vitamin D is available in two forms: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D2 is available from plant sterols, while vitamin D3 is derived from sunlight, diet and fortified foods (synthetic) [4]. Under ultraviolet (UV) B radiation from sunlight, 7-dehydrocholesterol is converted to pre-vitamin D3 in the skin [4]. Both forms of vitamin D are subsequently converted to the active form by undergoing two hydroxylation steps [4]. The first hydroxylation occurs in the liver to form 25-hydroxyvitamin D2 and D3 [25(OH) D2 and D3], which are in turn converted into the biologically active Z-VAD-FMK molecular weight compound, 1,25-dihydroxyvitamin D3,[1,25(OH)2D3], (calcitriol) by hydroxylation in the kidney [2, 4]. Serum 25-hydroxyvitamin D [25(OH)D] concentration is indicative of vitamin D stores in the body. Patients with CKD are more likely to have lower levels of 25(OH)D than those without kidney disease. In a study conducted in Boston, USA, kidney disease was found to be a major risk factor for low serum 25(OH)D in hospitalized patients [5]. Reasons for CKD patients developing vitamin D deficiency could include reduction in sunlight exposure due to inactivity and lower intake of vitamin D-rich foods [6]. Furthermore, in CKD patients with proteinuria, urinary loss of vitamin D-binding proteins (DBP) is high [6]. A recent study conducted in dialysis patients in the USA identified black race, female sex, winter season, and hypoalbuminemia as predictors of vitamin D deficiency [7]. Another cross-sectional study involving 1026 pre-dialysis CKD patients of any Galunisertib stage revealed that low glomerular filtration rate (GFR) (Ozagrel winter season, obesity, proteinuria, hypoalbuminemia, diabetes mellitus (DM) and hypertension were associated with vitamin D deficiency [8]. To date, similar analyses have not been conducted in the Asian CKD patient population. The Asian population is different from the US population due to differences in geographical location and the climate in which they live. In addition, the amount of sunlight exposure, skin color and genetics are also different. Thus, the potential risk factors of vitamin D deficiency in Asian CKD patients could be different. Currently, the risk factors for vitamin D deficiency in CKD patients in Singapore (1��22�� north of the equator), a sun-rich country, are unknown. As such, the aim of this study is to identify clinical and demographic parameters which are potential risk factors for vitamin D deficiency in multiethnic pre-dialysis patients in Singapore. These identified predictors will be useful to clinicians for the prediction of vitamin D deficiency, so that replacement with vitamin D supplements can be initiated early in CKD patients, before their kidney function deteriorates.