Vitamin D, cardiovascular disease, and survival in dialysis patients

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Dialysis patients have an increased burden of cardiovascular disease, with >70% of patients dying from a cardiovascular event. Several recent retrospective cohort studies have shown an association of treatment with calcitriol or its analogs and improved survival. The similar findings of these studies increase the validity of the observations, but these studies are subject to biases inherent in this type of study design. In particular, the nonrandom choice to treat, lack of information on concomitant medications, and differences in characteristics of patients who are treated compared with those not treated can lead to significant bias. Thus, prospective studies are needed. Two, small, uncontrolled, prospective studies showed improvement in left ventricular hypertrophy in dialysis patients treated with α-calcidiol or calcitriol, and there is abundant animal and in vitro studies showing biological plausibility. Thus, given the available evidence, it seems prudent to advise that most dialysis patients receive some form of vitamin D while we await results of a prospective interventional trial. The unknown is what type and how much to give, and whether this approach is safe, especially in patients with low levels of PTH.

Fingerprint

Vitamin D
Dialysis
Cardiovascular Diseases
Survival
Calcitriol
Prospective Studies
Calcifediol
Left Ventricular Hypertrophy
Cohort Studies
Retrospective Studies

Keywords

  • Calcitriol
  • Chronic kidney disease
  • Dialysis
  • Heart
  • Paricalcitol
  • Vitamin D

ASJC Scopus subject areas

  • Surgery

Cite this

@article{a3d2b239e03149d1af38a3ddd449ee8f,
title = "Vitamin D, cardiovascular disease, and survival in dialysis patients",
abstract = "Dialysis patients have an increased burden of cardiovascular disease, with >70{\%} of patients dying from a cardiovascular event. Several recent retrospective cohort studies have shown an association of treatment with calcitriol or its analogs and improved survival. The similar findings of these studies increase the validity of the observations, but these studies are subject to biases inherent in this type of study design. In particular, the nonrandom choice to treat, lack of information on concomitant medications, and differences in characteristics of patients who are treated compared with those not treated can lead to significant bias. Thus, prospective studies are needed. Two, small, uncontrolled, prospective studies showed improvement in left ventricular hypertrophy in dialysis patients treated with α-calcidiol or calcitriol, and there is abundant animal and in vitro studies showing biological plausibility. Thus, given the available evidence, it seems prudent to advise that most dialysis patients receive some form of vitamin D while we await results of a prospective interventional trial. The unknown is what type and how much to give, and whether this approach is safe, especially in patients with low levels of PTH.",
keywords = "Calcitriol, Chronic kidney disease, Dialysis, Heart, Paricalcitol, Vitamin D",
author = "Sharon Moe",
year = "2007",
month = "12",
doi = "10.1359/jbmr.07s218",
language = "English",
volume = "22",
journal = "Journal of Bone and Mineral Research",
issn = "0884-0431",
publisher = "Wiley-Blackwell",
number = "SUPPL. 2",

}

TY - JOUR

T1 - Vitamin D, cardiovascular disease, and survival in dialysis patients

AU - Moe, Sharon

PY - 2007/12

Y1 - 2007/12

N2 - Dialysis patients have an increased burden of cardiovascular disease, with >70% of patients dying from a cardiovascular event. Several recent retrospective cohort studies have shown an association of treatment with calcitriol or its analogs and improved survival. The similar findings of these studies increase the validity of the observations, but these studies are subject to biases inherent in this type of study design. In particular, the nonrandom choice to treat, lack of information on concomitant medications, and differences in characteristics of patients who are treated compared with those not treated can lead to significant bias. Thus, prospective studies are needed. Two, small, uncontrolled, prospective studies showed improvement in left ventricular hypertrophy in dialysis patients treated with α-calcidiol or calcitriol, and there is abundant animal and in vitro studies showing biological plausibility. Thus, given the available evidence, it seems prudent to advise that most dialysis patients receive some form of vitamin D while we await results of a prospective interventional trial. The unknown is what type and how much to give, and whether this approach is safe, especially in patients with low levels of PTH.

AB - Dialysis patients have an increased burden of cardiovascular disease, with >70% of patients dying from a cardiovascular event. Several recent retrospective cohort studies have shown an association of treatment with calcitriol or its analogs and improved survival. The similar findings of these studies increase the validity of the observations, but these studies are subject to biases inherent in this type of study design. In particular, the nonrandom choice to treat, lack of information on concomitant medications, and differences in characteristics of patients who are treated compared with those not treated can lead to significant bias. Thus, prospective studies are needed. Two, small, uncontrolled, prospective studies showed improvement in left ventricular hypertrophy in dialysis patients treated with α-calcidiol or calcitriol, and there is abundant animal and in vitro studies showing biological plausibility. Thus, given the available evidence, it seems prudent to advise that most dialysis patients receive some form of vitamin D while we await results of a prospective interventional trial. The unknown is what type and how much to give, and whether this approach is safe, especially in patients with low levels of PTH.

KW - Calcitriol

KW - Chronic kidney disease

KW - Dialysis

KW - Heart

KW - Paricalcitol

KW - Vitamin D

UR - http://www.scopus.com/inward/record.url?scp=39749096575&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=39749096575&partnerID=8YFLogxK

U2 - 10.1359/jbmr.07s218

DO - 10.1359/jbmr.07s218

M3 - Article

C2 - 18290731

AN - SCOPUS:39749096575

VL - 22

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - SUPPL. 2

ER -