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Vitamin D testers have different test results if there is chronic kidney disease – Sept 2019

Chronic kidney disease is a main confounding factor for 25-vitamin D measurement

J Bras Nefrol. 2019 Sep 26. doi: 10.1590/2175-8239-JBN-2019-0053.
Hanna Karla Andrade Guapyassú Machado, Carolina Steller Wagner Martins, Vanda Jorgetti, Rosilene Motta Elias, Rosa Maria Affonso Moysés
Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia

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BACKGROUND: Current guidelines recommend assessment of 25-vitamin D status in patients with chronic kidney disease (CKD). Although significant differences among assays have been described, the impact of CKD on this variability has never been tested.

METHODS: We tested the variability between two 25-vitamin D assays in patients with CKD (eGFR < 60 mL/min/1.73m2) who had consecutive 25-vitamin D measurements in 2015 (

  • Assay 1 - Diasorin LIASON 25 TOTAL - D assay®) and 2016 (
  • Assay 2 - Beckman Coulter Unicel Xl 800®).

The cohort consisted of 791 adult patients (122 with normal renal function and 669 with CKD - 33, 30, and 37% in stages 3, 4, and 5 on dialysis, respectively).

RESULTS: Levels of 25-vitamin D were lower and the prevalence of hypovitaminosis D using assay 1 was higher than using assay 2 in patients with CKD, regardless of similar levels of calcium, phosphate, and parathyroid hormone. As kidney function decreased, the percentage of disagreement between the assays increased.

CONCLUSION: There is a noteworthy variability between assays in patients with CKD such that the diagnosis of hypovitaminosis D is modified. The mechanism behind this result is still unclear and might be due to a possible interference in the analytical process. However, the clinical significance is unquestionable, as the supplementation of vitamin D can be erroneously prescribed to these patients.


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13084 CKD confounding.jpg admin 02 Dec, 2019 46.73 Kb 1145
13083 Chronic kidney disease is a main confounding factor.pdf admin 02 Dec, 2019 182.57 Kb 479