Vitamin D deficiency is associated with mortality in the medical intensive care unit

Venkatram, Sindhaghatta; Chilimuri, Sridhar; Adrish, Muhammad; Salako, Abayomi; Patel, Madanmohan; Diaz‐Fuentes, Gilda

doi:10.1186/cc10585

Cited by 170 publications

(172 citation statements)

References 56 publications

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“…Recent studies have reported the incidence of vitamin D deficiency in intensive care patients to be 17%-82% (2,3). This is quite a wide range, and in this study we observed vitamin D deficiency in 77.9% of all patients.…”

Section: Discussionsupporting

confidence: 53%

“…Calcitriol activates the vitamin D receptors in the cells, and this triggers the endocrine and autocrine effects of vitamin D. Vitamin D plays a major role in calcium homeostasis and bone metabolism, as well as in the immunoregulatory system (1). Vitamin D deficiency is defined as serum calcidiol levels below 25 ng mL -1 , and the incidence in intensive care patients varies between 17% and 82% (1)(2)(3). Reduced formation of calcitriol in the tissues might lead to impaired immune responses, mucosal barriers and endothelial Objective: Vitamin D is a fat-soluble vitamin that plays a major role in the regulation of bone and calcium metabolism and has effects on the immune and cardiovascular systems.…”

Section: Introductionmentioning

confidence: 99%

“…V itamin D is a fat-soluble vitamin consisting of two bio-equivalent forms, vitamin D 2 and Vitamin D 3 . Vitamin D 2 is obtained from vegetables and oral supplements.…”

Section: Introductionmentioning

confidence: 99%

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Serum Vitamin D Level at ICU Admission and Mortality

Atalan¹,

Güçyetmez²

2017

Turk J Anaesth Reanim

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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Serum Vitamin D Level at ICU Admission and Mortality

Atalan¹,

Güçyetmez²

2017

Turk J Anaesth Reanim

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“…As Moraes RB. et al and our study, Venkatram S. et al [44] suggested vitamin D levels under 10 ng/dl predicted hospital mortality in 83.6 % of their cohort. Gruson D et al suggested that 1,25 (OH)D and its ratio to PTH to be strongly and independently predict cardiovascular mortality in chronic heart failure [45].…”

Section: A) B)mentioning

confidence: 79%

Sequential vitamin D and parathyroid hormone measurement in patients with septic shock: Could they be prognostic marker in septic shock

Yeter

Aktepe

Topeli

2018

j-ebr

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A B S T R A C T Aim:Hypocalcemia is a common clinical problem in critically-ill patients and it is associated with increased morbidity and mortality. The aim of this study was to investigate serum calcium, vitamin D and parathyroid hormone (PTH) levels in surviving and non-surviving septic shock patients. Method: Patients with septic shock criteria and who were older than 18 years of age were included, whereas patients with diseases influencing calcium homeostasis were excluded. Demographic and laboratory parameters were recorded prospectively. Results: 41 patients, 20 of which were male were included in the study. The median (min-max) age of study population was 67 (19-88) years. Frequency of hypocalcemia in the study population was 29.2% and 68.2% according to corrected calcium and ionized calcium, respectively. On the day septic shock was diagnosed (day 1), median vitamin D levels of survivors and non-survivors were 8.7 ng/ml (4.3-30.4) and 5.3 ng/ml (1.0-21.7), respectively (p=0.05). On the same day, median PTH levels of survivors and non-survivors were 94 ng/L (16.9-1746) and 49 ng/L (6.6-339), respectively (p=0.042). Although vitamin D levels were suppressed and PTH levels were elevated in non-survivors at day 5, this change was not statistically significant (p=0.19 and p=0.187). Conclusion: Hypocalcemia is frequent in septic shock patients, whereas vitamin D levels were low and PTH levels were high in the diagnosis day. These results suggest that vitamin D is suppressed by septic shock at non-surviving patients during course of septic shock. Parathyroid hormone may be a marker for worse outcome in critically ill patients.

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“…The findings, reported by Amrein and colleagues [32], have revealed that the vast majority (87%) of ICU patients had low or very low concentrations of vitamin D, which was positively correlated with mortality. The study carried out by Venkatram and colleagues [33] demonstrated a correlation between the concentration of 25(OH)D in patients in a multi-specialized ICU and hospital mortality. Extremely low levels of vitamin D were found in 77% of patients.…”

Section: Significance Of Vitamin D In Icu Patientsmentioning

confidence: 99%

Vitamin D in critically ill patients

Matysiak-Luśnia

2016

Anaesthesiol Intensive Ther

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Vitamin D deficiency is a commonly observed global phenomenon, both in the general population and in hospitalized patients, including critically ill patients. Vitamin D deficiency is associated with multiple adverse health outcomes, including increased morbidity and mortality in the general population and in critically ill patients. Vitamin D is a fatsoluble vitamin that plays an important role in bone metabolism. However, Vitamin D is also a steroid hormone that exerts multiple pleiotropic effects. Vitamin D regulates immunity, inflammation, cell proliferation, differentiation, apoptosis, and angiogenesis. There is growing evidence of a close relationship between vitamin D insufficiency and various systemic disorders, i.e., type II diabetes, certain types of cancer, obesity, and cardiovascular morbidities. The purpose of this article is to present the current knowledge on the relationship between vitamin D status and critical illness. Key words: vitamin D, critical illness, intensive care, critically illAnaesthesiology Intensive Therapy 2016, vol. 48, no 3, 201-207 There is mounting evidence of the role of vitamin D in blood serum as a factor determining the course and prognosis of numerous diseases. Knowledge of the molecular basis of vitamin D action, its extraosseous effects and its significant role in the prevention and treatment of chronic diseases, especially inflammatory diseases, is growing. This paper presents the current state of knowledge regarding vitamin D, particularly its role in critically ill patients treated in intensive care units (ICUs). PRODUCTION AND METABOLISM OF VITAMIN DVitamin D belongs to the group of steroid chemical compounds with the general formula C 28 H 43 OH. The group contains vitamin D1 (a mixture of cholecalciferol and lumisterol occurring in cod liver oil, a compound with a similar structure as vitamin D but without the same activity), vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D2 occurs in plants, whereas vitamin D3 is produced in human and animal skin, mainly in the keratocytes of the proliferative epithelium, mediated by ultraviolet radiation (specifically UVB radiation). The compounds are activated in the liver by hydroxylation to 25-hydroxyderivatives and subsequently in other organs to 1,25-dihydroxyderivatives. The latter conversion occurs primarily in the kidneys and is mediated by parathormone (PTH). Calcitriol (1,25-dihydroxycholecalciferol) is an active form of vitamin D3, a substance of hormonal action regulating many organs and tissues. Although the metabolic effects of vitamin D2 and vitamin D3 are similar, they bind with different types of plasma proteins. As a result, the action of vitamin D3 is longer and 2-10-fold more effective than vitamin D2.Vitamin D3 is one of a few vitamins that the body is able to produce endogenously; therefore, it does not fulfil the definition of a vitamin. Ultraviolet radiation is required for the production of Vitamin D3 in the body, more specifically UVB (wavelength of 280−315 nm), which e...

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Vitamin D deficiency is associated with mortality in the medical intensive care unit

Cited by 170 publications

References 56 publications

Serum Vitamin D Level at ICU Admission and Mortality

Serum Vitamin D Level at ICU Admission and Mortality

Sequential vitamin D and parathyroid hormone measurement in patients with septic shock: Could they be prognostic marker in septic shock

Vitamin D in critically ill patients

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