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Hemodialysis with low vitamin D increases risk of 2 health problems by 10 percent – Aug 2020

The use of activated vitamin D and risks of hospitalization for infection and amputation in incident hemodialysis patients in Taiwan: a nationwide population-based cohort study

BMC Nephrology volume 21, Article number: 331 (2020)
Jo-Yen Chao, Chung-Yi Li, Ming-Cheng Wang & Yea-Huei Kao Yang

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Kidney category listing has 193 items

see also Overview Kidney and vitamin D
Search VitaminDWiki for dialysis OR haemodialysis 878 items not in PDF as of Aug 2020
Search VitaminDWiki for kidney transplant 798 items as of June 2019
"Chronic Kidney Disease" OR CKD 874 items as of Jan 2018

Calcitriol category listing has 46 items along with related searches

Kidney Intervention trials using Vitamin D:


Overview Kidney and vitamin D contains the following summary

  • FACT: Kidney is the primary way to activate vitamin D
  • FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
  • FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
  • FACT: There are many on-going intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
  • FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
  • FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
  • Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
      Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
    Calcitriol - which bypasses the need for the kidney to activate vitamin D
      Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
        Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012
  • Category Kidney and Vitamin D contains 193 items

 Download the PDF from VitaminDWiki
Statistically significant: amputation and infection
Image
Note: veritcal axis varies

Background
Hemodialysis patients have a high risk of mortality. The most common causes of death are cardiovascular disease and infection. The potential hazard or benefit associated with vitamin D use and cardiovascular or infection outcome is poorly characterized.

Methods
We conducted a retrospective observational cohort study by recruiting 52,757 patients older than 20 years from Taiwan National Health Insurance Research Database (NHIRD) who initiated maintenance hemodialysis between 2001 and 2009. Patients who were prescribed activated vitamin D before the 360th day from hemodialysis initiation were defined as vitamin D users. The primary outcome of interest includes occurrence of acute myocardial infarction (AMI), ischemic stroke, lower limb amputation, and hospitalization for infection, respectively, while death events are treated as competing events. We conducted competing risk analysis using subdistribution hazard regression model to estimate subdistribution hazard ratios (SHRs) in relation to various outcomes.

Results
During the median follow-up of 1019 days, the vitamin D users had a lower crude mortality rate, lower incidences of AMI, ischemic stroke, amputation, and hospitalization for infection compared with non-users. Taking into consideration competing events of death, vitamin D users were associated with a lower hazard of lower limb amputation (SHR 0.84 [95% CI, 0.74–0.96]) and hospitalization for infection (SHR 0.90 [95% CI, 0.87–0.94]), but not AMI or ischemic stroke, after adjustment for potential confounders. Subgroup analyses and dose response evaluation both showed a consistent association of activated vitamin D treatment with decreased risk of amputation and infection.

Conclusion
The findings suggest that therapeutic activated vitamin D use in hemodialysis patients may be beneficial for decreasing infection events and amputation, of which the latter is a complication of peripheral vascular disease, rather than reducing major atherosclerotic cardiovascular events such as AMI or ischemic stroke.


Created by admin. Last Modification: Thursday August 6, 2020 18:56:37 GMT-0000 by admin. (Version 5)

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14131 hemodialysis infection.jpg admin 06 Aug, 2020 18:41 194.47 Kb 36
14130 hemodialysis infection.pdf PDF 2020 admin 06 Aug, 2020 18:40 991.96 Kb 24
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