{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:42:32Z","timestamp":1786650152813,"version":"build-2736575974"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Anemia is common in Chronic Kidney Disease (CKD) and diabetes is a major leading risk factor for it. In Diabetic Kidney Disease (DKD), it worsens more, which further increases cardiovascular morbidity and mortality. Despite of adequate iron stores anemia persist, which may be due to impaired iron release from body stores that is unable to meet the demand for erythropoiesis (also called reticuloendothelial cell iron blockade). High parathyroid hormone (PTH) along with vitamin D, may be attributable for anemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A cross-sectional study of 150 advanced (Stage 4 &amp; 5) pre dialyzed DKD patients (GFR &lt;30ml\/min\/1.73 m2), aged 40-70 years were included over a period of 1 year. Any other concomitant illness\/ drugs leading to anemia were excluded. Serum samples were collected and urea, creatinine, hemoglobin, iron profile, vitamin D, iPTH, uric acid, calcium, phosphorous and albumin levels were measured. A data base was constructed on Microsoft Excel 2007 and statistical analyses were performed using the SPSS software version 20.0 (IBM, NY, USA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Stage 5 DKD had more pronounced anemia compared to stage 4 DKD (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Hemoglobin (Hb) was inversely correlated with iPTH (r = -0.74,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and was associated with vitamin D deficiency (r = 0.51,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) but not with serum ferritin. DKD patients with low eGFR (r = -0.6,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), vitamin D (r = -0.43,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and serum calcium (r = -0.37,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) had higher iPTH. Secondary hyperparathyroidism (beta=-0.005;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and Vitamin D (beta=0.053;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01) were strong predictor for Hb while parameters of iron profile was not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>An efficient control of PTH hypersecretion is therefore required to achieve a better management of anemia as well as mineral metabolism in DKD patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_174_17","type":"journal-article","created":{"date-parts":[[2018,9,3]],"date-time":"2018-09-03T06:01:59Z","timestamp":1535954519000},"page":"815-818","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Association of Vitamin D and secondary hyperparathyroidism with anemia in diabetic kidney disease"],"prefix":"10.4103","volume":"7","author":[{"given":"Satyendra Kumar","family":"Sonkar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harendra Pratap","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyanendra Kumar","family":"Sonkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sant","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-28-20260109","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.2337\/dc08-0779","article-title":"Anemia, diabetes, and chronic kidney disease","volume":"32","author":"Mehdi","year":"2009","journal-title":"Diabetes Care"},{"key":"R2-28-20260109","doi-asserted-by":"crossref","first-page":"289","DOI":"10.3949\/ccjm.73.3.289","article-title":"Anemia in chronic kidney disease: Causes, diagnosis, treatment","volume":"73","author":"Nurko","year":"2006","journal-title":"Cleve Clin J Med"},{"key":"R3-28-20260109","doi-asserted-by":"crossref","first-page":"12","DOI":"10.2337\/diaspect.21.1.12","article-title":"Anemia in patients with chronic kidney disease","volume":"21","author":"O\u2019Mara","year":"2008","journal-title":"Diabetes Spectr"},{"key":"R4-28-20260109","doi-asserted-by":"crossref","first-page":"613","DOI":"10.3949\/ccjm.83a.15065","article-title":"Anemia of chronic kidney disease: Treat it, but not too aggressively","volume":"83","author":"Nakhoul","year":"2016","journal-title":"Cleve Clin J Med"},{"key":"R6-28-20260109","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1111\/nep.12493","article-title":"Anaemia management and mortality risk in newly visiting patients with chronic kidney disease in Japan: The CKD-ROUTE study","volume":"20","author":"Iimori","year":"2015","journal-title":"Nephrology (Carlton"},{"key":"R7-28-20260109","first-page":"397","article-title":"Outcomes of secondary hyperparathyroidism in chronic kidney disease and the direct costs of treatment","volume":"13","author":"Joy","year":"2007","journal-title":"J Manag Care Pharm"},{"key":"R8-28-20260109","doi-asserted-by":"crossref","first-page":"268","DOI":"10.4103\/2230-8210.176348","article-title":"Management of anemia in patients with diabetic kidney disease: A consensus statement","volume":"20","author":"Bajaj","year":"2016","journal-title":"Indian J Endocrinol Metab"},{"key":"R9-28-20260109","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1186\/s40064-015-1001-z","article-title":"Predictors of anemia in a multi-ethnic chronic kidney disease population: A case-control study","volume":"4","author":"Lau","year":"2015","journal-title":"Springerplus"},{"key":"R10-28-20260109","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1093\/ndt\/gft021","article-title":"Renal anaemia and EPO hyporesponsiveness associated with vitamin D deficiency: The potential role of inflammation","volume":"28","author":"Icardi","year":"2013","journal-title":"Nephrol Dial Transplant"},{"key":"R11-28-20260109","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1681\/ASN.2011111078","article-title":"Mechanisms of anemia in CKD","volume":"23","author":"Babitt","year":"2012","journal-title":"J Am Soc Nephrol"},{"key":"R12-28-20260109","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/0974-2727.115935","article-title":"Association of secondary hyperparathyroidism with hemoglobin level in patients with chronic kidney disease","volume":"5","author":"Chutia","year":"2013","journal-title":"J Lab Physicians"},{"key":"R13-28-20260109","first-page":"161","article-title":"Intensification of anaemia by secondary hyperparathyroidism in hemodialysis patients","volume":"14","author":"Baradaran","year":"2001","journal-title":"Med J Islam Acad Sci"},{"key":"R14-28-20260109","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1159\/000351229","article-title":"The association between parathyroid hormone levels and hemoglobin in diabetic and nondiabetic participants in the National Kidney Foundation's Kidney Early Evaluation Program","volume":"3","author":"Memon","year":"2013","journal-title":"Cardiorenal Med"},{"key":"R15-28-20260109","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1093\/ndt\/17.suppl_5.28","article-title":"Role of secondary hyperparathyroidism in erythropoietin resistance of chronic renal failure patients","volume":"17","author":"Dr\u00fceke","year":"2002","journal-title":"Nephrol Dial Transplant"},{"key":"R16-28-20260109","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1159\/000013563","article-title":"Hyperparathyroidism and anemia in renal failure","volume":"20","author":"Gallieni","year":"2000","journal-title":"Am J Nephrol"},{"key":"R17-28-20260109","doi-asserted-by":"crossref","first-page":"913","DOI":"10.2215\/CJN.06040710","article-title":"Secondary hyperparathyroidism: Pathogenesis, disease progression, and therapeutic options","volume":"6","author":"Cunningham","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"R18-28-20260109","doi-asserted-by":"crossref","first-page":"105","DOI":"10.4103\/2230-8210.81939","article-title":"Relationship of associated secondary hyperparathyroidism to serum fibroblast growth factor-23 in end stage renal disease: A case-control study","volume":"15","author":"Sliem","year":"2011","journal-title":"Indian J Endocrinol Metab"},{"key":"R19-28-20260109","first-page":"195","article-title":"Intensification of anemia by secondary hyperthyroidism in hemodialysis patients","volume":"28","author":"Nasri","year":"2003","journal-title":"Iran J Med Sci"},{"key":"R21-28-20260109","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.3349\/ymj.2016.57.5.1159","article-title":"Association between vitamin D deficiency and anemia in patients with end-stage renal disease: A Cross-sectional study","volume":"57","author":"Kim","year":"2016","journal-title":"Yonsei Med J"},{"key":"R22-28-20260109","first-page":"511","article-title":"Serum vitamin D levels in patients with chronic kidney disease","volume":"12","author":"Rozita","year":"2013","journal-title":"EXCLI J"},{"key":"R23-28-20260109","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1159\/000044878","article-title":"Red blood cell osmotic fragility in chronically hemodialyzed patients","volume":"78","author":"Wu","year":"1998","journal-title":"Nephron"},{"key":"R24-28-20260109","first-page":"48","article-title":"Association of secondary hyperparathyroidism with anemia in patients with end-stage renal disease; A review on current knowledge","volume":"4","author":"Mousavi","year":"2016","journal-title":"J Parathyroid Dis"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01697686-201807040-00028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:04:38Z","timestamp":1786647878000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01697686-201807040-00028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_174_17","relation":{},"ISSN":["2249-4863"],"issn-type":[{"value":"2249-4863","type":"print"}],"subject":[],"published":{"date-parts":[[2018,7]]}}}