Vitamin D Deficiency in Dialysis Patients: Effect of Dialysis Modality and Implications on Outcome

Gracia-Iguacel, Carolina; Gallar, Paloma; Qureshi, Abdul Rashid; Ortega, Olimpia; Mon, Carmen; Ortiz, Milagros; Villarreal, Isabel; García-Lacalle, Concepción; Olieta, Aniana; Sánchez, María Sánchez; Herrero, Juan Carlos; Vigil, Ana; Lindholm, Bengt; Carrero, Juan Jesús

doi:10.1053/j.jrn.2010.03.005

Cited by 34 publications

(18 citation statements)

References 41 publications

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“…On the other hand, baseline serum levels of 25OH vitamin D, but not 1,25OH vitamin D, kept an independent, significant association with the risk of progression of CV disease. The consistency of this association was remarkable and agrees with previous studies, showing that low serum vitamin D levels portend mortality, and more specifically CV outcomes, both in the general population [23,24] and in patients with different stages of CKD [7,20,[25][26][27][28] , including those treated with PD [29,30] . However, the significance of this association still needs some clarification.…”

Section: Subclinical Atherosclerosis In Pd Patientssupporting

confidence: 89%

Low Serum Levels of Vitamin D are Associated with Progression of Subclinical Atherosclerotic Vascular Disease in Peritoneal Dialysis Patients: A Prospective, Multicenter Study

Fontán

Sans²,

Rubio

et al. 2017

Nephron

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Background: The prevalence of subclinical atherosclerosis and the main predictors of progression of this condition in patients undergoing peritoneal dialysis (PD) have been insufficiently investigated. Objectives and Method: Following a prospective, multicenter, observational design, we studied 237 patients who were treated with PD for ≥3 months, without any clinical background of cardiovascular (CV) disease. Our objectives were the following: (1) to investigate the prevalence of subclinical atherosclerosis, as compared to a control group of age- and sex-matched healthy individuals, and (2) to disclose PD technique-related predictors of progression of disease during a 24-month follow-up period. We used vascular ultrasound for characterization of subclinical atherosclerotic disease. Main Results: A total of 123 patients (51.9%) vs. 79 controls (33.5%) presented ≥1 carotid plaque, and 114 patients (48.3%) vs. 72 controls (30.5%) ≥1 femoral plaque, at baseline evaluation (p < 0.0005). Progression of disease, either in clinical or ultrasound (new plaques) terms, affected 62.6% of patients. Multivariate analysis identified age, carotid intima-media thickness, presence of ≥1 carotid plaque, and serum levels of 25OH vitamin D and C-reactive protein (CRP) at baseline as independent correlates of progression of atherosclerotic disease. On the contrary, PD technique-related variables did not show any association with this outcome. Conclusions: Atherosclerotic vascular disease is frequent among asymptomatic patients undergoing PD. Older age, pre-existent disease (assessed by vascular ultrasound), and serum levels of 25OH vitamin D and CRP are independent markers of the progression of this condition. These findings may contribute to improve identification of subpopulations with a high risk of CV events, deserving intensified measures of prevention.

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Section: Subclinical Atherosclerosis In Pd Patientssupporting

confidence: 89%

Low Serum Levels of Vitamin D are Associated with Progression of Subclinical Atherosclerotic Vascular Disease in Peritoneal Dialysis Patients: A Prospective, Multicenter Study

Fontán

Sans²,

Rubio

et al. 2017

Nephron

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“…HD modality of higher efficiency (in the current study HF-HD compared with LF-HD) was associated with better preserved plasma 25(OH)D concentrations [16,17]. As Table 4.…”

Section: Discussionmentioning

confidence: 56%

Self-Reported Physical Activity, Quality of Life, and Psychological Status in Relation to Plasma 25-Hydroxyvitamin D Concentration in Patients Treated with Hemodialysis

Grzegorzewska

Izdebska

Niepolski³

et al. 2016

Kidney Blood Press Res

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Background/Aims: Vitamin D status is announced among factors that may influence physical performance and mental health. Our aim was to evaluate self-reported physical activity, quality of life, psychiatric functioning, and affects with respect to plasma 25-hydroxyvitamin D [25(OH)D] concentrations in HD patients. Methods: The study was carried out in HD patients not receiving vitamin D supplements (n = 112). IPAQ-L, QLI-D, GHQ-28, and PANAS were used in psychological evaluations. Plasma 25(OH)D concentration was determined by a chemiluminescent microparticle immunoassay. Results: Plasma 25(OH)D level was suboptimal in all patients (14.6 ± 4.1 ng/ml). Adjusted correlates of 25(OH)D concentration included the GG genotype of GC rs7041 (β±SE: 1.77± 0.70, P=0.014), female sex (β±SE: -2.19±0.75, P=0.004), and treatment with high flux HD (β±SE: 2.59±0.69, P=0.0003). In adjusted analyses, circulating 25(OH)D showed the independent association with total activity related to domestic and gardening domain (β±SE: 53.2±23.8, P=0.028), and with moderate-intensity activities (β±SE: 54.9±27.4, P=0.048), but not with any of quality of life, psychiatric functioning, or affects measures. Conclusions: Vitamin D status is independently positively associated with physical activity in HD patients. Quality of life and mental health do not seem to be associated with circulating 25(OH)D under condition of its suboptimal levels.

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“…30 In hemodialysis patients, 76%-94% were found to have 25(OH) D <30 ng/mL. [31][32][33][34][35] A high prevalence of vitamin D deficiency of 87% was also observed in a large cohort of peritoneal dialysis patients. 36 Studies have shown that African-Americans have lower 25(OH)D levels compared with whites.…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease

Friedl

Zitt

2017

IJNRD

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Secondary hyperparathyroidism (sHPT) represents the adaptive and very often, finally, maladaptive response of the organism to control the disturbed homeostasis of calcium, phosphorus, and vitamin D metabolism caused by declining renal function in chronic kidney disease (CKD). sHPT leads to cardiovascular and extravascular calcifications and is directly linked to an increased risk of cardiovascular morbidity and mortality as well as excess all-cause mortality. Vitamin D plays an important role in the development of sHPT. CKD patients are characterized by a high prevalence of hypovitaminosis D. Supplementation with both vitamin D prohormones cholecalciferol and ergocalciferol enables the achievement and maintenance of a normal vitamin D status when given in adequate doses over an appropriate treatment period. In patients with earlier stages of CKD, sHPT is influenced by and can be successfully treated with vitamin D prohormone supplementation, whereas in patients with very late stages of CKD and those requiring dialysis, treatment with prohormones seems to be of limited efficacy. This review gives an overview of the pathogenesis of sHPT, summarizes vitamin D metabolism, and discusses the existing literature regarding the role of vitamin D prohormone in the treatment of sHPT in patients with CKD. Keywords: cholecalciferol, CKD, CKD-MBD, dialysis, ergocalciferol, SHPT. Pathogenesis of secondary hyperparathyroidism (sHPT) in chronic kidney disease (CKD)sHPT represents the adaptive and very often, finally, maladaptive response of the organism to control the disturbed homeostasis of calcium, phosphorus, and vitamin D metabolism caused by declining renal function in CKD. These disturbances in mineral metabolism lead to vascular 1,2 and valvular 3 calcifications and are directly linked to an increased risk of cardiovascular morbidity and mortality as well as excess all-cause mortality. 4 Apart from extra-skeletal side effects, sHPT also leads to profound alterations in bone metabolism, which become obvious in the different forms of renal osteodystrophy.5 This clinical syndrome encompassing mineral, bone, and cardiovascular abnormalities has been termed "CKD-related mineral and bone disorder" (CKD-MBD).6 sHPT generally develops in CKD stage 3 with an estimated glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 , and its prevalence increases as kidney function declines. 7,8 Initially, it is characterized by normocalcemia with intermittent transient hypocalcemia, fasting normo-or hypophosphatemia, and reduced 1,25(OH) 2 D 3 (calcitriol) concentration, together with increasing levels of fibroblast growth factor 23 (FGF23), a decrease in plasma soluble Klotho, and the development of renal osteodystrophy. [8][9][10][11] These alterations result in increased secretion

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Vitamin D Deficiency in Dialysis Patients: Effect of Dialysis Modality and Implications on Outcome

Cited by 34 publications

References 41 publications

Low Serum Levels of Vitamin D are Associated with Progression of Subclinical Atherosclerotic Vascular Disease in Peritoneal Dialysis Patients: A Prospective, Multicenter Study

Low Serum Levels of Vitamin D are Associated with Progression of Subclinical Atherosclerotic Vascular Disease in Peritoneal Dialysis Patients: A Prospective, Multicenter Study

Self-Reported Physical Activity, Quality of Life, and Psychological Status in Relation to Plasma 25-Hydroxyvitamin D Concentration in Patients Treated with Hemodialysis

Vitamin D prohormone in the treatment of secondary hyperparathyroidism in patients with chronic kidney disease

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