Vitamin D levels and early mortality among incident hemodialysis patients.

Published

Journal Article

Vitamin D deficiency is associated with cardiovascular disease, the most common cause of mortality in hemodialysis patients. To investigate the relation between blood levels of 25-hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D) with hemodialysis outcomes, we measured baseline vitamin D levels in a cross-sectional analysis of 825 consecutive patients from within a prospective cohort of incident US hemodialysis patients. Of these patients, 78% were considered vitamin D deficient with 18% considered severely deficient. Calcium, phosphorus, and parathyroid hormone levels correlated poorly with 25D and 1,25D concentrations. To test the association between baseline vitamin D levels and 90-day mortality, we selected the next 175 consecutive participants who died within 90 days and compared them to the 750 patients who survived in a nested case-control analysis. While low vitamin D levels were associated with increased mortality, significant interaction was noted between vitamin D levels, subsequent active vitamin D therapy, and survival. Compared to patients with the highest 25D or 1,25D levels who received therapy, untreated deficient patients were at significantly increased risk for early mortality. Our study shows that among incident hemodialysis patients, vitamin D deficiency is common, correlates poorly with other components of mineral metabolism and is associated with increased early mortality.

Full Text

Duke Authors

Cited Authors

  • Wolf, M; Shah, A; Gutierrez, O; Ankers, E; Monroy, M; Tamez, H; Steele, D; Chang, Y; Camargo, CA; Tonelli, M; Thadhani, R

Published Date

  • October 2007

Published In

Volume / Issue

  • 72 / 8

Start / End Page

  • 1004 - 1013

PubMed ID

  • 17687259

Pubmed Central ID

  • 17687259

International Standard Serial Number (ISSN)

  • 0085-2538

Digital Object Identifier (DOI)

  • 10.1038/sj.ki.5002451

Language

  • eng

Conference Location

  • United States