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Vitamin D supplementation and mortality risk in chronic kidney disease: a meta-analysis of 20 observational studies.
BMC Nephrol. 2013 Sep 25; 14:199.BN

Abstract

BACKGROUND

Vitamin D insufficiency correlates with mortality risk among patients with chronic kidney disease (CKD). The survival benefits of active vitamin D treatment have been assessed in patients with CKD not requiring dialysis and in patients with end stage renal disease (ESRD) requiring dialysis.

METHODS

MEDLINE, Embase, the Cochrance Library, and article reference lists were searched for relevant observational trials. The quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS) checklist. Pooled effects were calculated as hazard ratios (HR) using random-effects models.

RESULTS

Twenty studies (11 prospective cohorts, 6 historical cohorts and 3 retrospective cohorts) were included in the meta-analysis., Participants receiving vitamin D had lower mortality compared to those with no treatment (adjusted case mixed baseline model: HR, 0.74; 95% confidence interval [95% CI], 0.67-0.82; P <0.001; time-dependent Cox model: HR, 0.71; 95% CI, 0.57-0.89; P <0.001). Participants that received calcitriol (HR, 0.63; 95% CI, 0.50-0.79; P <0.001) and paricalcitol (HR, 0.43 95% CI, 0.29-0.63; P <0.001) had a lower cardiovascular mortality. Patients receiving paricalcitol had a survival advantage over those that received calcitriol (HR, 0.95; 95% CI, 0.91-0.99; P <0.001).

CONCLUSIONS

Vitamin D treatment was associated with decreased risk of all-cause and cardiovascular mortality in patients with CKD not requiring dialysis and patients with end stage renal disease (ESRD) requiring dialysis. There was a slight difference in survival depending on the type of vitamin D analogue. Well-designed randomized controlled trials are necessary to assess the survival benefits of vitamin D.

Authors+Show Affiliations

Nephrology Department, General Hospital of Tianjin Medical University, No,I54 Anshan Road, Heping District, Tianjin 300052, China. linshan@medmail.com.cn.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Observational Study
Review

Language

eng

PubMed ID

24066946

Citation

Zheng, Zhenfeng, et al. "Vitamin D Supplementation and Mortality Risk in Chronic Kidney Disease: a Meta-analysis of 20 Observational Studies." BMC Nephrology, vol. 14, 2013, p. 199.
Zheng Z, Shi H, Jia J, et al. Vitamin D supplementation and mortality risk in chronic kidney disease: a meta-analysis of 20 observational studies. BMC Nephrol. 2013;14:199.
Zheng, Z., Shi, H., Jia, J., Li, D., & Lin, S. (2013). Vitamin D supplementation and mortality risk in chronic kidney disease: a meta-analysis of 20 observational studies. BMC Nephrology, 14, 199. https://doi.org/10.1186/1471-2369-14-199
Zheng Z, et al. Vitamin D Supplementation and Mortality Risk in Chronic Kidney Disease: a Meta-analysis of 20 Observational Studies. BMC Nephrol. 2013 Sep 25;14:199. PubMed PMID: 24066946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D supplementation and mortality risk in chronic kidney disease: a meta-analysis of 20 observational studies. AU - Zheng,Zhenfeng, AU - Shi,Huilan, AU - Jia,Junya, AU - Li,Dong, AU - Lin,Shan, Y1 - 2013/09/25/ PY - 2013/05/12/received PY - 2013/09/04/accepted PY - 2013/9/27/entrez PY - 2013/9/27/pubmed PY - 2014/7/23/medline SP - 199 EP - 199 JF - BMC nephrology JO - BMC Nephrol VL - 14 N2 - BACKGROUND: Vitamin D insufficiency correlates with mortality risk among patients with chronic kidney disease (CKD). The survival benefits of active vitamin D treatment have been assessed in patients with CKD not requiring dialysis and in patients with end stage renal disease (ESRD) requiring dialysis. METHODS: MEDLINE, Embase, the Cochrance Library, and article reference lists were searched for relevant observational trials. The quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS) checklist. Pooled effects were calculated as hazard ratios (HR) using random-effects models. RESULTS: Twenty studies (11 prospective cohorts, 6 historical cohorts and 3 retrospective cohorts) were included in the meta-analysis., Participants receiving vitamin D had lower mortality compared to those with no treatment (adjusted case mixed baseline model: HR, 0.74; 95% confidence interval [95% CI], 0.67-0.82; P <0.001; time-dependent Cox model: HR, 0.71; 95% CI, 0.57-0.89; P <0.001). Participants that received calcitriol (HR, 0.63; 95% CI, 0.50-0.79; P <0.001) and paricalcitol (HR, 0.43 95% CI, 0.29-0.63; P <0.001) had a lower cardiovascular mortality. Patients receiving paricalcitol had a survival advantage over those that received calcitriol (HR, 0.95; 95% CI, 0.91-0.99; P <0.001). CONCLUSIONS: Vitamin D treatment was associated with decreased risk of all-cause and cardiovascular mortality in patients with CKD not requiring dialysis and patients with end stage renal disease (ESRD) requiring dialysis. There was a slight difference in survival depending on the type of vitamin D analogue. Well-designed randomized controlled trials are necessary to assess the survival benefits of vitamin D. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/24066946/Vitamin_D_supplementation_and_mortality_risk_in_chronic_kidney_disease:_a_meta_analysis_of_20_observational_studies_ L2 - https://www.biomedcentral.com/1471-2369/14/199 DB - PRIME DP - Unbound Medicine ER -