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

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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

 Download the PDF from VitaminDWiki
Statistically significant: amputation and infection

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.

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VitaminDWiki: Kidney, Dialysis, and Vitamin D

• Poor kidney ==> poor conversion of Vitamin D
• Very poor kidney ==> Hemodialysis (filtering of blood)
• Some Hemodialysis devices filter out Vitamin D
• Some Hemodialysis centers used to restore Vitamin D
  • The US govt no longer compensates for vitamin D restoration, so centers are reluctqant to do it.
• Vitamin D appears essential to survive many critical illnesses - review Oct 2018
• Chronic kidney treatment by Vitamin D lacks consensus: type, how much – Sept 2018
• Hypothesis: Magnesium might prevent and treat Chronic Kidney Disease – April 2018

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Overview Kidney and vitamin D contains the following summary

• FACT: The Kidneys are not the primary way to activate vitamin D; the tissues are
• 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 ongoing 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: 38% of seniors have Chronic Kidney Disease and most are unaware of it CDC statistics 2020
• 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,
  Nanoemulstion vitamin D (inside cheek, topically) gets activated Vitamin D to the cells without the need for healthy kidney, liver, or intestine
  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 232 items

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39+ VitaminDWiki pages with HEMODIALYSIS etc in title

This list is automatically updated