Vitamin D as a Novel Nontraditional Risk Factor for Mortality in Hemodialysis Patients
We examined the prevalence of vitamin D deficiency in hemodialysis patients and tested the hypothesis that decreased levels of 25‐hydroxyvitamin D (25D) are associated with an increased risk for early all‐cause mortality. One hundred and two patients, 57 (56%) men and 45 (44%) women, mean age 60.5 ±...
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Veröffentlicht in: | Therapeutic apheresis and dialysis 2009-08, Vol.13 (4), p.268-272 |
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description | We examined the prevalence of vitamin D deficiency in hemodialysis patients and tested the hypothesis that decreased levels of 25‐hydroxyvitamin D (25D) are associated with an increased risk for early all‐cause mortality. One hundred and two patients, 57 (56%) men and 45 (44%) women, mean age 60.5 ± 13.1 years, were included in our study. Serum calcium and phosphorus levels were measured by routine laboratory methods. Parathyroid hormone (PTH) was measured by immunoassay and 25D by enzyme immunoassay. Patients were divided into two groups depending on the serum concentration of 25D: below or above 50 nmol/L. Survival rates were analyzed using the Kaplan–Meier survival curves. The Cox regression model was used to define potential variables effecting all‐cause mortality. The mean level of 25D in all patients was 58 ± 35.6 nmol/L, 52% of patients had 25D levels >50 nmol/L and 48% had levels of 10.5–50 nmol/L. Compared with men, women were more likely to be 25D deficient (67% vs. 37%; P = 0.005). Patients were observed from the date of laboratory measurement until their death or to a maximum of 730 days. Kaplan–Meier survival analysis showed that mortality in patients was significantly higher in the group with 25D levels ≤50 nmol/L (P |
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One hundred and two patients, 57 (56%) men and 45 (44%) women, mean age 60.5 ± 13.1 years, were included in our study. Serum calcium and phosphorus levels were measured by routine laboratory methods. Parathyroid hormone (PTH) was measured by immunoassay and 25D by enzyme immunoassay. Patients were divided into two groups depending on the serum concentration of 25D: below or above 50 nmol/L. Survival rates were analyzed using the Kaplan–Meier survival curves. The Cox regression model was used to define potential variables effecting all‐cause mortality. The mean level of 25D in all patients was 58 ± 35.6 nmol/L, 52% of patients had 25D levels >50 nmol/L and 48% had levels of 10.5–50 nmol/L. Compared with men, women were more likely to be 25D deficient (67% vs. 37%; P = 0.005). Patients were observed from the date of laboratory measurement until their death or to a maximum of 730 days. Kaplan–Meier survival analysis showed that mortality in patients was significantly higher in the group with 25D levels ≤50 nmol/L (P < 0.033). With Cox multivariable regression modeling, the PTH level (P < 0.029) turned out to be the only predictor of mortality in our patients. Using the definitions recommended in the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines, we found that our hemodialysis patients on average have vitamin D insufficiency. Our results indicate that patients with 25D levels ≤50 nmol/L are associated with higher all‐cause early mortality.</description><identifier>ISSN: 1744-9979</identifier><identifier>EISSN: 1744-9987</identifier><identifier>DOI: 10.1111/j.1744-9987.2009.00722.x</identifier><identifier>PMID: 19695057</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>25-Hydroxyvitamin D ; Aged ; Calcium - blood ; End-stage renal disease ; Female ; Hemodialysis ; Humans ; Kaplan-Meier Estimate ; Kidney Failure, Chronic - therapy ; Male ; Middle Aged ; Mortality ; Parathyroid Hormone - metabolism ; Phosphorus - blood ; Proportional Hazards Models ; Prospective Studies ; Regression Analysis ; Renal Dialysis - mortality ; Risk Factors ; Vitamin D - analogs & derivatives ; Vitamin D - blood ; Vitamin D deficiency ; Vitamin D Deficiency - complications</subject><ispartof>Therapeutic apheresis and dialysis, 2009-08, Vol.13 (4), p.268-272</ispartof><rights>2009 The Authors. Journal compilation © 2009 International Society for Apheresis</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4292-dea80e9e02edbb264a4ec0d542997b85af68303ceefe0eadcd2a37c29888e9153</citedby><cites>FETCH-LOGICAL-c4292-dea80e9e02edbb264a4ec0d542997b85af68303ceefe0eadcd2a37c29888e9153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1744-9987.2009.00722.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1744-9987.2009.00722.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19695057$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pečovnik-Balon, Breda</creatorcontrib><creatorcontrib>Jakopin, Eva</creatorcontrib><creatorcontrib>Bevc, Sebastjan</creatorcontrib><creatorcontrib>Knehtl, Masa</creatorcontrib><creatorcontrib>Gorenjak, Maksimiljan</creatorcontrib><title>Vitamin D as a Novel Nontraditional Risk Factor for Mortality in Hemodialysis Patients</title><title>Therapeutic apheresis and dialysis</title><addtitle>Ther Apher Dial</addtitle><description>We examined the prevalence of vitamin D deficiency in hemodialysis patients and tested the hypothesis that decreased levels of 25‐hydroxyvitamin D (25D) are associated with an increased risk for early all‐cause mortality. One hundred and two patients, 57 (56%) men and 45 (44%) women, mean age 60.5 ± 13.1 years, were included in our study. Serum calcium and phosphorus levels were measured by routine laboratory methods. Parathyroid hormone (PTH) was measured by immunoassay and 25D by enzyme immunoassay. Patients were divided into two groups depending on the serum concentration of 25D: below or above 50 nmol/L. Survival rates were analyzed using the Kaplan–Meier survival curves. The Cox regression model was used to define potential variables effecting all‐cause mortality. The mean level of 25D in all patients was 58 ± 35.6 nmol/L, 52% of patients had 25D levels >50 nmol/L and 48% had levels of 10.5–50 nmol/L. Compared with men, women were more likely to be 25D deficient (67% vs. 37%; P = 0.005). Patients were observed from the date of laboratory measurement until their death or to a maximum of 730 days. Kaplan–Meier survival analysis showed that mortality in patients was significantly higher in the group with 25D levels ≤50 nmol/L (P < 0.033). With Cox multivariable regression modeling, the PTH level (P < 0.029) turned out to be the only predictor of mortality in our patients. Using the definitions recommended in the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines, we found that our hemodialysis patients on average have vitamin D insufficiency. Our results indicate that patients with 25D levels ≤50 nmol/L are associated with higher all‐cause early mortality.</description><subject>25-Hydroxyvitamin D</subject><subject>Aged</subject><subject>Calcium - blood</subject><subject>End-stage renal disease</subject><subject>Female</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Parathyroid Hormone - metabolism</subject><subject>Phosphorus - blood</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Regression Analysis</subject><subject>Renal Dialysis - mortality</subject><subject>Risk Factors</subject><subject>Vitamin D - analogs & derivatives</subject><subject>Vitamin D - blood</subject><subject>Vitamin D deficiency</subject><subject>Vitamin D Deficiency - complications</subject><issn>1744-9979</issn><issn>1744-9987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFtP3DAQRq2qqFzav1D5rU8Jjp3EttQXBOUiFti2dHm0ZpOJ5CUXsL1l99_jsKvlFUv2jDTfGUuHEJqxNIvneJFmMs8TrZVMOWM6ZUxynq4-kYPd4POul3qfHHq_YIzzXIgvZD_TpS5YIQ_IbGYDdLanZxQ8BXo7_Mc2vn1wUNtghx5a-sf6R3oOVRgcbeK9GVyA1oY1jeAldkNtoV176-kUgsU--K9kr4HW47dtPSL_zn_dn14mk7uLq9OTSVLlXPOkRlAMNTKO9XzOyxxyrFhdxKGWc1VAUyrBRIXYIEOoq5qDkBXXSinUWSGOyI_N3ic3PC_RB9NZX2HbQo_D0hsphJa8UGNSbZKVG7x32JgnZztwa5MxM0o1CzP6MqM7M0o1b1LNKqLft58s5x3W7-DWYgz83ARebIvrDy829yfT2EQ82eDWB1ztcHCPppRCFubh9sLMHs5-X__NhCnFKzjXlW0</recordid><startdate>200908</startdate><enddate>200908</enddate><creator>Pečovnik-Balon, Breda</creator><creator>Jakopin, Eva</creator><creator>Bevc, Sebastjan</creator><creator>Knehtl, Masa</creator><creator>Gorenjak, Maksimiljan</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200908</creationdate><title>Vitamin D as a Novel Nontraditional Risk Factor for Mortality in Hemodialysis Patients</title><author>Pečovnik-Balon, Breda ; Jakopin, Eva ; Bevc, Sebastjan ; Knehtl, Masa ; Gorenjak, Maksimiljan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4292-dea80e9e02edbb264a4ec0d542997b85af68303ceefe0eadcd2a37c29888e9153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>25-Hydroxyvitamin D</topic><topic>Aged</topic><topic>Calcium - blood</topic><topic>End-stage renal disease</topic><topic>Female</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Parathyroid Hormone - metabolism</topic><topic>Phosphorus - blood</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Regression Analysis</topic><topic>Renal Dialysis - mortality</topic><topic>Risk Factors</topic><topic>Vitamin D - analogs & derivatives</topic><topic>Vitamin D - blood</topic><topic>Vitamin D deficiency</topic><topic>Vitamin D Deficiency - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pečovnik-Balon, Breda</creatorcontrib><creatorcontrib>Jakopin, Eva</creatorcontrib><creatorcontrib>Bevc, Sebastjan</creatorcontrib><creatorcontrib>Knehtl, Masa</creatorcontrib><creatorcontrib>Gorenjak, Maksimiljan</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Therapeutic apheresis and dialysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pečovnik-Balon, Breda</au><au>Jakopin, Eva</au><au>Bevc, Sebastjan</au><au>Knehtl, Masa</au><au>Gorenjak, Maksimiljan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vitamin D as a Novel Nontraditional Risk Factor for Mortality in Hemodialysis Patients</atitle><jtitle>Therapeutic apheresis and dialysis</jtitle><addtitle>Ther Apher Dial</addtitle><date>2009-08</date><risdate>2009</risdate><volume>13</volume><issue>4</issue><spage>268</spage><epage>272</epage><pages>268-272</pages><issn>1744-9979</issn><eissn>1744-9987</eissn><abstract>We examined the prevalence of vitamin D deficiency in hemodialysis patients and tested the hypothesis that decreased levels of 25‐hydroxyvitamin D (25D) are associated with an increased risk for early all‐cause mortality. One hundred and two patients, 57 (56%) men and 45 (44%) women, mean age 60.5 ± 13.1 years, were included in our study. Serum calcium and phosphorus levels were measured by routine laboratory methods. Parathyroid hormone (PTH) was measured by immunoassay and 25D by enzyme immunoassay. Patients were divided into two groups depending on the serum concentration of 25D: below or above 50 nmol/L. Survival rates were analyzed using the Kaplan–Meier survival curves. The Cox regression model was used to define potential variables effecting all‐cause mortality. The mean level of 25D in all patients was 58 ± 35.6 nmol/L, 52% of patients had 25D levels >50 nmol/L and 48% had levels of 10.5–50 nmol/L. Compared with men, women were more likely to be 25D deficient (67% vs. 37%; P = 0.005). Patients were observed from the date of laboratory measurement until their death or to a maximum of 730 days. Kaplan–Meier survival analysis showed that mortality in patients was significantly higher in the group with 25D levels ≤50 nmol/L (P < 0.033). With Cox multivariable regression modeling, the PTH level (P < 0.029) turned out to be the only predictor of mortality in our patients. Using the definitions recommended in the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines, we found that our hemodialysis patients on average have vitamin D insufficiency. Our results indicate that patients with 25D levels ≤50 nmol/L are associated with higher all‐cause early mortality.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>19695057</pmid><doi>10.1111/j.1744-9987.2009.00722.x</doi><tpages>5</tpages></addata></record> |
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subjects | 25-Hydroxyvitamin D Aged Calcium - blood End-stage renal disease Female Hemodialysis Humans Kaplan-Meier Estimate Kidney Failure, Chronic - therapy Male Middle Aged Mortality Parathyroid Hormone - metabolism Phosphorus - blood Proportional Hazards Models Prospective Studies Regression Analysis Renal Dialysis - mortality Risk Factors Vitamin D - analogs & derivatives Vitamin D - blood Vitamin D deficiency Vitamin D Deficiency - complications |
title | Vitamin D as a Novel Nontraditional Risk Factor for Mortality in Hemodialysis Patients |
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