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Hemodialysis deaths less likely if take vitamin D, especially if highest dose vitamin D – Nov 2018

Assessing the effect of oral activated vitamin D on overall survival in hemodialysis patients: a landmark analysis

BMC Nephrology201819:309, https://doi.org/10.1186/s12882-018-1111-2
Jo-Yen Chao, Hsu-Chih Chien, Te-Hui Kuo, Yu-Tzu Chang, Chung-Yi Li, Ming-Cheng Wang and Yea-Huei Kao YangE

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Deaths
per 100
person-year
Adjusted
Risk
Non-users (not prescribed ?) 13 1.0
Conventional dose vitamin D8.70.88
High dose vitamin D 5.9 0.66

Note: The data is for ACTIVE vitamin D prescriptions
Unknown: How many people actually took the prescription
Unknown: How many people took normal vitamin D

Background
Patients with end stage renal disease have a high all-cause and cardiovascular mortality. Secondary hyperparathyroidism and vitamin D deficiency are considered part of the mechanism for the excess mortality observed. We aimed to evaluate the relationship between vitamin D use and all-cause mortality.

Methods
In this retrospective cohort study, we included all incident patients who started hemodialysis in Taiwan between 2001 and 2009. Patients were followed from landmark time, i.e., the 360th day from hemodialysis initiation, through the end of 2010 or death. We evaluated the association between activated vitamin D use or not before landmark time and all-cause mortality using conditional landmark analysis with Cox regression. We used group-based trajectory model to categorize high-dose versus average-dose users to evaluate dose-response relationships.

Results
During the median follow-up of 1019 days from landmark time, vitamin D users had a lower crude mortality rate than non-users (8.98 versus 12.93 per 100 person-years). Compared with non-users, vitamin D users was associated with a lower risk of death in multivariate Cox model (HR 0.91 [95% CI, 0.87–0.95]) and after propensity score matching (HR 0.94 [95% CI, 0.90–0.98]). High-dose vitamin D users had a lower risk of death than conventional-dose users, HR 0.75 [95% CI, 0.63–0.89]. The association of vitamin D treatment with reduced mortality did not alter when we re-defined landmark time as the 180th day or repeated analyses in patients who underwent hemodialysis in the hospital setting.

Conclusions: Our findings supported the survival benefits of activated vitamin D among incident hemodialysis patients.


Created by admin. Last Modification: Friday January 20, 2023 17:01:45 GMT-0000 by admin. (Version 11)

Attached files

ID Name Comment Uploaded Size Downloads
10821 Hemo death user vs non user.jpg admin 10 Nov, 2018 18.97 Kb 484
10820 High dose hemodialysis.pdf admin 10 Nov, 2018 910.84 Kb 552