Measuring of vitamin D receptor quantity in monocytes, lymphocytes and natural killer cells in chronic kidney disease

It is known that chronic kidney disease (CKD) has serious effects on the immune system. Likewise, many roles of vitamin D in the organism have been revealed by the observation of VDR in numerous tissues. There are also several experimental studies that showing the effects of vitamin D on the immune system. In this study, we aimed to investigate the relationship between vitamin D levels and vitamin D receptor levels in monocytes, lymphocytes and natural killer cells in chronic kidney disease (CKD) patients. In this study, routine renal biochemical parameters were studied in the outpatient clinic, which had not yet undergone renal replacement therapy in our polyclinic with the diagnosis of CKD. In this study, total 49 patients which 25-(OH)D3 level less than 20 and 34 patients greater than 30 who met the inclusion criteria were included. Immune system cells (natural killer cells, monocytes, lymphocytes) were isolated from blood samples taken from volunteers. Cell markers were identified by detecting surface markers (monocyte - CD14, T lymphocyte - CD3, CD4 and CD8, natural killer cell - CD56) and the amount of vitamin D receptor levels (VDR) measured in all cell groups. At the same time, information on age, sex, place of residence, skin color, how much time is spent on sunlight, what percentage of the body has directly exposed to sunlight, whether or not being a car owner, whether or not to having sea bathes, what type of swimming suits have been using have obtained. Other than this, the subjects were also asked about the frequency of fish, offal dishes, eggs, milk and dairy products, orange juice and tea consumption, whether D vitamin therapy/supplementation was taken, the cause of kidney disease and gastrointestinal system related surgery. All this information was recorded and statistical analyzes were made. 83 patients were stratified into two groups by their serum 25-(OH)D3 levels; low VD group (< 20 ng / ml) and those with normal VD levels (> 30 ng / ml). Also, 83 patients were also classified into three groups by their CKD stages as stage 3 (GFR 30-59 ml / min / 1.73 m2), stage 4 (GFR 15-29 ml / min / 1.73 m2) and stage 5 (GFR <15 ml / min / 1,73 m2). In all groups, the amount of vitamin D receptor in the monocytes, lymphocytes and natural killer cells were compared with etiological, nutritional, environmental and socioeconomic factors. There was no significant difference in VDR between groups seperated according to 25-(OH)D3 levels. There was no significant difference in the amount of VDR between the CKD stages and the groups separated by CKD stages. Significant differences were found between the 25-(OH)D3 levels and consumption of offal and orange, car ownership, the percentage of body exposure to sunlight, beach attendance. No correlations were found between VDR level and either serum vitamin D levels and CKD stages. It was observed that the consumption of offal and orange and the vitamin D level were statistically related. The effect of the change in eating habits on the immune system has been examined. Such as negative correlation between car ownership and significant relationship between having sea baths and vitamin D levels seemed interesting and worths to be publicised by media tools such as newspapers, magazines and interviews. Consequently, our results may be used in increasing vitamin D consciousness in the society and informing it about the possible tools in increasing serum VD levels up to optimal.