Vitamin B12 Deficiency In Chronic Kidney Disease
IOSR Journal of Dental and Medical Sciences
Anaemia has long been recognised as a feature of CKD. Severe Chronic Kidney Disease has an adverse effect on haematopoiesis. There is imbalance between haematopoiesis and increased destruction. Many Patients with CKD show smear and megaloblastosis on examination of the bone marrow. This suggests that Vitamin B 12 & folic acid deficiency might be additional factors contributing to inadequate haematopoiesis in uraemia. The most common causes of megaloblastosis are cobalamin (vitamin B 12 ) and
... tamin B 12 ) and folate deficiencies. Various studies carried out on Asian Indians with normal renal function show that they have low levels of Vitamin B 12 and high levels of homocysteine and methylmalonic acid. Objectives:1) To Define prevalence of Vitamin B 12 deficiency in Chronic Kidney Disease (CKD) patients; 2) To study the contributory role of dietary factors to Vitamin B 12 deficiency. Materials&Methods: A hospital based cross sectional study was conducted including 50 patients suffering from Chronic Kidney Disease. After taking informed consent, patients underwent history recording, clinical examination along with relevant anthropometrical measurements.Laboratory investigations included complete blood count, urine examination, blood sugar profile, lipid profile and renal function test. Serum vitaminB 12 & homocysteine levels were done by Kit based Chemiluminescent Micro-particle Immunoassay (CMIA). Results: Out of total 50 subjects, 31 were males and 19 were females with a mean age of 45.26 +/-9.63 years. Vitamin B 12 deficiency was observed in 56% of CKD patients. Significant association was observed between presence of neurological symptoms and presence of vitamin B 12 deficiency. Similarly mean duration of CKD was also significantly associated with presence of Vitamin B 12 deficiency. Conclusion: Present study showed high prevalence of Vitamin B 12 deficiency in CKD patients. Most of the patients had associated neurological, hematological and gastro-intestinal symptoms. Hence all the treating nephrologists should anticipate the deficiency of Vitamin B 12 in CKD patients and take appropriate measures for its control.