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Vitamin D levels and early mortality among incident hemodialysis patients.
Kidney Int 2007; 72(8):1004-13KI

Abstract

Vitamin D deficiency is associated with cardiovascular disease, the most common cause of mortality in hemodialysis patients. To investigate the relation between blood levels of 25-hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D) with hemodialysis outcomes, we measured baseline vitamin D levels in a cross-sectional analysis of 825 consecutive patients from within a prospective cohort of incident US hemodialysis patients. Of these patients, 78% were considered vitamin D deficient with 18% considered severely deficient. Calcium, phosphorus, and parathyroid hormone levels correlated poorly with 25D and 1,25D concentrations. To test the association between baseline vitamin D levels and 90-day mortality, we selected the next 175 consecutive participants who died within 90 days and compared them to the 750 patients who survived in a nested case-control analysis. While low vitamin D levels were associated with increased mortality, significant interaction was noted between vitamin D levels, subsequent active vitamin D therapy, and survival. Compared to patients with the highest 25D or 1,25D levels who received therapy, untreated deficient patients were at significantly increased risk for early mortality. Our study shows that among incident hemodialysis patients, vitamin D deficiency is common, correlates poorly with other components of mineral metabolism and is associated with increased early mortality.

Authors+Show Affiliations

Renal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17687259

Citation

Wolf, M, et al. "Vitamin D Levels and Early Mortality Among Incident Hemodialysis Patients." Kidney International, vol. 72, no. 8, 2007, pp. 1004-13.
Wolf M, Shah A, Gutierrez O, et al. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int. 2007;72(8):1004-13.
Wolf, M., Shah, A., Gutierrez, O., Ankers, E., Monroy, M., Tamez, H., ... Thadhani, R. (2007). Vitamin D levels and early mortality among incident hemodialysis patients. Kidney International, 72(8), pp. 1004-13.
Wolf M, et al. Vitamin D Levels and Early Mortality Among Incident Hemodialysis Patients. Kidney Int. 2007;72(8):1004-13. PubMed PMID: 17687259.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D levels and early mortality among incident hemodialysis patients. AU - Wolf,M, AU - Shah,A, AU - Gutierrez,O, AU - Ankers,E, AU - Monroy,M, AU - Tamez,H, AU - Steele,D, AU - Chang,Y, AU - Camargo,C A,Jr AU - Tonelli,M, AU - Thadhani,R, Y1 - 2007/08/08/ PY - 2007/8/10/pubmed PY - 2007/12/13/medline PY - 2007/8/10/entrez SP - 1004 EP - 13 JF - Kidney international JO - Kidney Int. VL - 72 IS - 8 N2 - Vitamin D deficiency is associated with cardiovascular disease, the most common cause of mortality in hemodialysis patients. To investigate the relation between blood levels of 25-hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D) with hemodialysis outcomes, we measured baseline vitamin D levels in a cross-sectional analysis of 825 consecutive patients from within a prospective cohort of incident US hemodialysis patients. Of these patients, 78% were considered vitamin D deficient with 18% considered severely deficient. Calcium, phosphorus, and parathyroid hormone levels correlated poorly with 25D and 1,25D concentrations. To test the association between baseline vitamin D levels and 90-day mortality, we selected the next 175 consecutive participants who died within 90 days and compared them to the 750 patients who survived in a nested case-control analysis. While low vitamin D levels were associated with increased mortality, significant interaction was noted between vitamin D levels, subsequent active vitamin D therapy, and survival. Compared to patients with the highest 25D or 1,25D levels who received therapy, untreated deficient patients were at significantly increased risk for early mortality. Our study shows that among incident hemodialysis patients, vitamin D deficiency is common, correlates poorly with other components of mineral metabolism and is associated with increased early mortality. SN - 0085-2538 UR - https://www.unboundmedicine.com/medline/citation/17687259/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0085-2538(15)52770-1 DB - PRIME DP - Unbound Medicine ER -