OBJECTIVE: Although several studies have shown poorer survival among individuals with 25-hydroxy (OH) vitamin D deficiency, data on patients receiving dialysis are limited. Using data from the Comprehensive Dialysis Study (CDS), we tested the hypothesis that patients new to dialysis with low serum concentrations of 25-OH vitamin D would experience higher mortality and hospitalizations. DESIGN: The CDS is a prospective cohort study.We recruited participants from 56 dialysis units located throughout the United States. SUBJECTS AND INTERVENTION: We obtained data on demographics, comorbidites, and laboratory values from the CDS Patient Questionnaire as well as the Medical Evidence Form (CMS form 2728). Participants provided baseline serum samples for 25-OH vitamin D measurements. MAIN OUTCOME MEASURE: We ascertained time to death and first hospitalization as well as number of first-year hospitalizations via the U.S. Renal Data System standard analysis files. We used Cox proportional hazards to determine the association between 25-OH vitamin D tertiles and survival and hospitalization. For number of hospitalizations in the first year, we used negative binomial regression. RESULTS: The analytic cohort was composed of 256 patients with Patient Questionnaire data and 25-OH vitamin D concentrations. The mean age of participants was 62 (±14.0) years, and mean follow-up was 3.8 years. Patients with 25-OH vitamin D concentrations in the lowest tertile (<10.6 ng/mL) at the start of dialysis experienced higher mortality (adjusted hazard ratio 1.75, 95% confidence interval [CI] 1.03-2.97) as well as hospitalization (adjusted hazard ratio 1.76, 95% CI 1.24-2.49). Patients in the lower 2 tertiles (<15.5 ng/mL) experienced a higher rate of hospitalizations in the first year (incidence rate ratio 1.70 [95% CI 1.06-2.72] for middle tertile, 1.66 [95% CI 1.10-2.51] for lowest tertile). CONCLUSION: We found a sizeable increase in mortality and hospitalization for patients on dialysis with severe 25-OH vitamin D deficiency.
OBJECTIVE: Although several studies have shown poorer survival among individuals with 25-hydroxy (OH) vitamin Ddeficiency, data on patients receiving dialysis are limited. Using data from the Comprehensive Dialysis Study (CDS), we tested the hypothesis that patients new to dialysis with low serum concentrations of 25-OH vitamin D would experience higher mortality and hospitalizations. DESIGN: The CDS is a prospective cohort study.We recruited participants from 56 dialysis units located throughout the United States. SUBJECTS AND INTERVENTION: We obtained data on demographics, comorbidites, and laboratory values from the CDSPatient Questionnaire as well as the Medical Evidence Form (CMS form 2728). Participants provided baseline serum samples for 25-OH vitamin D measurements. MAIN OUTCOME MEASURE: We ascertained time to death and first hospitalization as well as number of first-year hospitalizations via the U.S. Renal Data System standard analysis files. We used Cox proportional hazards to determine the association between 25-OH vitamin D tertiles and survival and hospitalization. For number of hospitalizations in the first year, we used negative binomial regression. RESULTS: The analytic cohort was composed of 256 patients with Patient Questionnaire data and 25-OH vitamin D concentrations. The mean age of participants was 62 (±14.0) years, and mean follow-up was 3.8 years. Patients with 25-OH vitamin D concentrations in the lowest tertile (<10.6 ng/mL) at the start of dialysis experienced higher mortality (adjusted hazard ratio 1.75, 95% confidence interval [CI] 1.03-2.97) as well as hospitalization (adjusted hazard ratio 1.76, 95% CI 1.24-2.49). Patients in the lower 2 tertiles (<15.5 ng/mL) experienced a higher rate of hospitalizations in the first year (incidence rate ratio 1.70 [95% CI 1.06-2.72] for middle tertile, 1.66 [95% CI 1.10-2.51] for lowest tertile). CONCLUSION: We found a sizeable increase in mortality and hospitalization for patients on dialysis with severe 25-OH vitamin Ddeficiency.
Authors: Nancy G Kutner; Kirsten L Johansen; George A Kaysen; Sarah Pederson; Shu-Cheng Chen; Lawrence Y Agodoa; Paul W Eggers; Glenn M Chertow Journal: Clin J Am Soc Nephrol Date: 2009-03-04 Impact factor: 8.237
Authors: Rajnish Mehrotra; Dulcie A Kermah; Isidro B Salusky; Myles S Wolf; Ravi I Thadhani; Yi-Wen Chiu; David Martins; Sharon G Adler; Keith C Norris Journal: Kidney Int Date: 2009-08-05 Impact factor: 10.612
Authors: Suetonia C Palmer; David O McGregor; Petra Macaskill; Jonathan C Craig; Grahame J Elder; Giovanni F M Strippoli Journal: Ann Intern Med Date: 2007-12-18 Impact factor: 25.391
Authors: Mariusz Mieczkowski; Paweł Żebrowski; Ewa Wojtaszek; Tomasz Stompór; Jerzy Przedlacki; Zbigniew Bartoszewicz; Janusz Sierdziński; Zofia Wańkowicz; Stanisław Niemczyk; Joanna Matuszkiewicz-Rowińska Journal: Med Sci Monit Date: 2014-11-10