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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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VitaminDWiki pages with DIALYSIS in title (21 as of Sept 2022)

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Items found: 21
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Dialysis patients 23 percent more likely to live if had just 10 ng more Vitamin D – meta-analysis Feb 2018 29 Sep, 2021
Peritoneal dialysis probably consumes a lot more vitamin D than haemodialysis 29 Sep, 2021
Vitamin D is needed during Dialysis – initially only 29 pcnt tested, extensive education raised it to 32 pcnt – May 2020 28 Feb, 2021
Kidney Dialysis often filters out Vitamin D, a problem for vegetarians and others- Feb 2021 14 Feb, 2021
Dialysis patients who added Vitamin D were 41 percent less likely to get infection – Meta-analysis July 2018 31 Jul, 2018
Vitamin D Receptor activators (such as paricalcitol) treat dialysis patients similarly – Aug 2017 27 Aug, 2017
Kidney Dialysis clinics reluctant to add vitamin D treatment as they are not reimbursed – Oct 2012 27 Jul, 2017
Peritoneal dialysis probably consumes a lot more vitamin D than haemodialysis – April 2014 24 Jun, 2016
Dialysis patients need real vitamin D – Editorial July 2013 08 Apr, 2015
Peritoneal Dialysis nicely treated by active vitamin D – July 2013 04 Feb, 2015
Those Dialysis patients with low vitamin D were 75% more likely to die – July 2013 12 Dec, 2013
Virtually all black dialysis patients with low albumin are vitamin D deficient in the winter – Mar 2010 23 Jul, 2013
Dialysis patients with less than 15 ng of vitamin D did not feel well – March 2011 23 Jul, 2013
Dialysis patients with low vitamin D were 2.7 X more likely to die of heart problems – Feb 2011 23 Jul, 2013
Telomeres longer for dialysis patients having higher levels of vitamin D – March 2012 11 May, 2013
5700 IU of vitamin D helped half with chronic kidney disease if not having dialysis – July 2012 01 Sep, 2012
Majority of blacks on dialysis were vitamin D deficient - March 2010 12 Nov, 2011
Dialysis patients with higher levels of vitamin D were better – May 2011 24 May, 2011
Wearable dialysis device being tested which also converts vitamin D - Mar 2011 04 Mar, 2011
Clinical measures identify vitamin D deficiency in dialysis – Feb 2010 19 Jul, 2010
1700 IU per day of vit D2 was not enough to help dialysis No value for 'modification_date_major'

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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.


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