Ability of vitamin D receptor activator to prevent pulmonary congestion in advanced chronic kidney disease

Sueta, Shinichi; Morozumi, Kunio; Takeda, Asami; Horike, Keiji; Otsuka, Yasuhiro; Shinjo, Hibiki; Murata, Mitsunobu; Kato, Yuki; Goto, Kazunori; Inaguma, Daijo

doi:10.1007/s10157-014-0994-x

Cited by 6 publications

(4 citation statements)

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“…Pleiotropic effects of activated vitamin D include improving endothelial function, inhibition of vascular smooth muscle proliferation and vascular calcification, suppression of renin production, and modification of inflammatory response [ 15 – 18 ]. Treatment with activated vitamin D is associated with lower incidence of left ventricular hypertrophy, myocardial fibrosis, and pulmonary congestion [ 17 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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BackgroundPatients 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.MethodsIn 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.ResultsDuring 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.ConclusionsOur findings supported the survival benefits of activated vitamin D among incident hemodialysis patients.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-1111-2) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…The mean (± standard deviation) age at starting dialysis was 67.5 ± 13.1 years, and the percentage of male patients was 68.1%. We identified a cohort of patients receiving maintenance dialysis with similar age and sex distribution to that reported in the Japanese Society of Dialysis Therapy registry data [ 20 , 21 ]. Patients with late referral showed significantly higher proportion of the following: clinical history of volume overload, peripheral artery disease, and dementia.…”

Section: Resultsmentioning

confidence: 99%

Unfavorable effects of history of volume overload and late referral to a nephrologist on mortality in patients initiating dialysis: a multicenter prospective cohort study in Japan

et al. 2018

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BackgroundPatients with late referral and positive history of volume overload may have a poor prognosis after initiating dialysis due to insufficient and/or inadequate management of complications of renal failure and the lack of better dialysis preparation. Little is known about the influence of the relationship between history of volume overload and late referral on prognosis.MethodsWe analyzed 1475 patients who had initiated dialysis for the first time from October 2011 to September 2013. late referral was defined as referral to a nephrologist < 3 months before dialysis initiation. The major outcomes were all-cause death and deaths due to cardiovascular diseases (CVD). The impact of late referral and history of volume overload on all-cause mortality was assessed by Cox proportional hazards models.ResultsAmong 1475 patients, the mean patient age was 67.5 years. During the median follow-up of 2.2 years, 260 deaths occurred; 99 were due to CVD. Cox proportional hazards models demonstrated that late referral (adjusted hazard ratio [HR], 1.35; 95% confidence interval [CI], 1.00–1.82) and history of volume overload (adjusted HR, 1.39; 95% CI, 1.06–1.81) were risk factors for all-cause mortality. Furthermore, late referral coexisting was associated with a history of volume overload increased mortality (adjusted HR, 2.10; 95% CI, 1.39–3.16 versus absence of late referral without history of volume overload) after adjusting for age, sex, diabetes, atherosclerotic disease, and laboratory values.ConclusionsBoth late referral and history of volume overload were associated with increased risks of all-cause mortality.Trial registrationUniversity Hospital Medical Information Network (UMIN000007096). Registered 18 January 2012, retrospectively registered.https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000008349.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-0859-8) contains supplementary material, which is available to authorized users.

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“…In practice, activated vitamin D is indicated in CKD or ESRD patients with hypocalcemia and secondary hyperparathyroidism [ 8 ]. In observational studies, patients treated with activated vitamin D had a lower all-cause mortality rate, and a lower prevalence of pulmonary congestion, compared with those not treated [ 9 – 11 ]. Effects of activated vitamin D include suppression of renin synthesis, inhibition of vascular calcification, and modification of immune system [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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

Chao

Wang

et al. 2020

BMC Nephrol

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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.

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Ability of vitamin D receptor activator to prevent pulmonary congestion in advanced chronic kidney disease

Abstract: In this study, VDRA administration was associated with a low prevalence of pulmonary congestion in patients initiated on dialysis. Appropriate VDRA administration may prevent pulmonary congestion.

Cited by 6 publications

References 20 publications

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

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

Unfavorable effects of history of volume overload and late referral to a nephrologist on mortality in patients initiating dialysis: a multicenter prospective cohort study in Japan

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

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