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2.8X more likely to die of hemodialysis if low on vitamin D

Vitamin D Deficiency, Mortality, and Hospitalization in Hemodialysis Patients with or without Protein-Energy Wasting.- 2011

Nephron Clin Pract. 2011 Aug 11;119(3):c220-c226.
Fiedler R, Dorligjav O, Seibert E, Ulrich C, Markau S, Girndt M.
Department of Internal Medicine II, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.

Background:Vitamin D deficiency and protein-energy wasting (PEW) are highly prevalent in hemodialysis (HD) patients. The goal of our study was to investigate if a lack of vitamin D influences mortality and hospitalization of HD patients with or without PEW. Methods: In 81 chronic HD patients with different nutritional status assessed by the Malnutrition Inflammation Score (MIS), vitamin D deficiency (25-OH-vitamin D(3) levels ?30 nmol/l or ?12 ng/ml) was prospectively investigated for its prognostic impact on mortality and hospitalization. Over a 3-year follow-up, all-cause mortality and hospitalization were determined. The predictive value of low vitamin D levels and PEW as well as their combined effect were evaluated using a multivariate Cox regression model.

Results: Vitamin D deficiency was frequent in HD patients with and without PEW. It significantly increased mortality rate in HD patients (HR 2.76 (1.33-5.73), p < 0.01), which was aggravated by concomitant PEW (HR 5.88 (2.29-15.09), p < 0.001). The hospitalization rate, however, was not influenced independently by nutritional status.

Conclusions: Low 25-OH-vitamin D(3) concentration is an independent predictor for survival, but not for hospitalization of HD patients. It is not merely a malnutrition-associated finding, although a MIS ?8 further impaired survival prognosis.

Vitamin D status and mortality of German hemodialysis patients.- 2012

Anticancer Res. 2012 Jan ;32(1):391-5.
Krause R, Schober-Halstenberg HJ, Edenharter G, Haas K, Roth HJ, Frei U.
KfH Nephrological Center Moabit, Turmstr. 20A, 10559 Berlin, Germany. rolfdieter.krause at kfh-dialyse.de

AIM: The goal was to analyze the link between blood levels of calcidiol and all-cause, cardiac and infectious diseases, and mortality due to cancer in hemodialysis patients.

PATIENTS AND METHODS: This study retrospectively evaluated a representative sub-cohort (n=6,518) of German hemodialysis patients from the incidence cohorts 1997-2006.

RESULTS: Most (58.8%) were found to be vitamin D deficient (25(OH)D<20 ng/ml), with 41.2% being severely deficient (25(OH)D<12.5 ng/ml). All-cause mortality risk more than doubled in patients with severe deficiency (adjusted odds ratio (aOR)=2.67; 95% confidence interval (CI)=2.30-3.10; p<0.0001). Comparable data were obtained for mortality from cardiac disease (aOR=1.57; 95% CI=1.30-1.88; p<0.0001), infectious disease (aOR=1.48; 95% CI=1.15-1.90; p=0.0026), and cancer (aOR=1.51; 95% CI=1.09-2.08; p=0.0121), respectively.

CONCLUSION: These data highlight the need to ensure primarily adequate 25(OH)D levels in dialysis patients for an advantage of survival.

See also VitaminDWiki

VitaminDWiki pages with HEMODIALYSIS in title (15 as of Sept 2022)

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