Those Dialysis patients with low vitamin D were 75% more likely to die

Vitamin D Deficiency and Mortality in Patients Receiving Dialysis: The Comprehensive Dialysis Study

Journal of Renal Nutrition, Available online 19 July 2013, http://dx.doi.org/10.1053/j.jrn.2013.05.003

Shuchi Anand, MD∗, Corresponding author

Glenn M. Chertow, MD, MPH∗,

Kirsten L. Johansen, MD†, ‡,

Barbara Grimes, PhD§,

Lorien S. Dalrymple, MD, MPH¶,

George A. Kaysen, MD, PhD¶, ∗∗,

Manjula Kurella Tamura, MD, MPH∗, ††

∗ Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, California

† Nephrology Section, Department of Veterans Affairs Medical Center, San Francisco, California

‡ Division of Nephrology, Department of Medicine, University of California–San Francisco, San Francisco, California

§ Department of Epidemiology and Biostatistics, University of California–San Francisco, San Francisco, California

¶ Division of Nephrology, Department of Medicine, University of California–Davis, Davis, California

∗∗ Nephrology Section, Department of Veterans Affairs Medical Center, Mather, California

†† Department of Veterans Affairs Medical Center, Palo Alto Health Care System, Palo Alto, California

Objective: Although several studies have shown poorer survival among individuals with 25-hydroxy (OH) vitamin D deficiency, data on patients receiving dialysis are limited. Using data from the Comprehensive Dialysis Study (CDS), we tested the hypothesis that patients new to dialysis with low serum concentrations of 25-OH vitamin D would experience higher mortality and hospitalizations.

Design: The CDS is a prospective cohort study.We recruited participants from 56 dialysis units located throughout the United States.

Subjects and Intervention: We obtained data on demographics, comorbidites, and laboratory values from the CDS Patient Questionnaire as well as the Medical Evidence Form (CMS form 2728). Participants provided baseline serum samples for 25-OH vitamin D measurements.

Main Outcome Measure: We ascertained time to death and first hospitalization as well as number of first-year hospitalizations via the U.S. Renal Data System standard analysis files. We used Cox proportional hazards to determine the association between 25-OH vitamin D tertiles and survival and hospitalization. For number of hospitalizations in the first year, we used negative binomial regression.

Results: The analytic cohort was composed of 256 patients with Patient Questionnaire data and 25-OH vitamin D concentrations. The mean age of participants was 62 (±14.0) years, and mean follow-up was 3.8 years. Patients with 25-OH vitamin D concentrations in the lowest tertile (<10.6 ng/mL) at the start of dialysis experienced higher mortality (adjusted hazard ratio 1.75 , 95% confidence interval [CI] 1.03-2.97) as well as hospitalization (adjusted hazard ratio 1.76, 95% CI 1.24-2.49). Patients in the lower 2 tertiles (<15.5 ng/mL) experienced a higher rate of hospitalizations in the first year (incidence rate ratio 1.70 [95% CI 1.06-2.72] for middle tertile, 1.66 [95% CI 1.10-2.51] for lowest tertile).

Conclusion: We found a sizeable increase in mortality and hospitalization for patients on dialysis with severe 25-OH vitamin D deficiency.

---

See also VitaminDWiki

• Dialysis patients 23 percent more likely to live if had just 10 ng more Vitamin D – meta-analysis Feb 2018

• Dialysis patients with low vitamin D were 2.7 X more likely to die of heart problems – Feb 2011

• Virtually all black dialysis patients with low albumin are vitamin D deficient in the winter – Mar 2010

• Dialysis patients with less than 15 ng of vitamin D did not feel well – March 2011

• Dialysis patients need real vitamin D – Editorial July 2013 same journal

• Overview Kidney and vitamin D

• All items in Kidney and Vitamin D items

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