Death after surgery for chronic kidney disease 2.3 X more likely if low Vitamin D – March 2025

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Impact of vitamin D deficiency on postoperative outcomes in patients with chronic kidney disease undergoing surgery: a retrospective study

Sci Rep. 2025 Mar 21;15(1):9757. doi: 10.1038/s41598-025-93807-7.
Kuo-Chuan Hung 1 2, Ting-Sian Yu 3, I-Yin Hung 1 2, Jheng-Yan Wu 4 5, Ming Yew 1 2, I-Wen Chen 6 7

Although both chronic kidney disease (CKD) and vitamin D deficiency (VDD) are associated with increased surgical risk, their combined impact remains unclear. Using the TriNetX Analytics Network, we conducted a matched cohort study comparing postoperative outcomes in CKD patients with preoperative VDD (≤ 20 ng/mL) to those with normal vitamin D levels (≥ 30 ng/mL). The primary outcome was 30-day mortality; secondary outcomes included acute kidney injury (AKI), pneumonia, acute myocardial infarction (AMI), and atrial fibrillation/flutter (AF). After propensity score matching (21,033 patients per group), results showed that

• VDD was associated with higher 30-day mortality
  • (Odds ratio[OR]: 2.33, 95% confidence interval [CI] 1.91-2.85, p < 0.0001),
• AKI (OR:1.94, 95% CI1.80-2.10, p < 0.0001), and
• pneumonia (OR:1.76, 95% CI 1.15-2.70, p = 0.0087),

with no significant difference in AMI and AF. These associations persisted for 90 days. The impact of VDD on mortality and AKI was consistent across sex and CKD stages. Vitamin D insufficiency (21-29 ng/mL) showed attenuated but significant associations, suggesting a dose-dependent effect. In conclusion, preoperative VDD in patients with CKD is associated with increased risks of mortality, AKI, and pneumonia. These findings suggest the potential value of preoperative vitamin D screening and correction in patients with CKD.
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VitaminDWiki - 4 studies in both categories Kidney and Trauma/Surgery

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See also: Vitamin D is needed before many surgeries – many studies and RCTs