Vitamin D linked to reduced mortality rate in CKD

May 07, 2008

For patients with moderate to severe chronic kidney disease (CKD), treatment with activated vitamin D may reduce the risk of death by approximately one-fourth, suggests a study in the August Journal of the American Society of Nephrology.

Many patients with advanced CKD take the drug calcitriol, an oral form of activated vitamin D, to treat elevated levels of parathyroid hormone. "Although activated vitamin D is known to influence many biological processes, previous clinical knowledge is limited to its effect on parathyroid hormone levels," explains Dr. Bryan Kestenbaum of the University of Washington in Seattle, one of the study authors.

The study included 1,418 patients who had stage 3 to 4 CKD, which means moderately to severely reduced kidney function. All patients also had high parathyroid hormone levels (hyperparathyroidism), which can contribute to weakening of the bones in CKD. The researchers identified one group of patients who were being treated with calcitriol to lower their parathyroid hormone levels and another group who were not receiving calcitriol.

During a two-year follow-up period, mortality rates were compared for patients who were and were not taking calcitriol. "We then adjusted for differences in age, kidney function, parathyroid hormone levels, other illnesses, and other medications," says Dr. Kestenbaum.

In the adjusted analysis, the overall risk of death was about 26 percent lower for patients taking calcitriol. Patients on calcitriol were also less likely to develop end-stage renal disease, requiring dialysis to replace lost kidney function.

Overall, treatment with calcitriol was associated with a 20 percent reduction in the risk of either death or dialysis. The reduction in mortality with calcitriol was unrelated to its effect on parathyroid hormone levels.

"Recently, there has been an increased focus on the effects of vitamin D beyond those on bone health," Dr. Kestenbaum comments. "Vitamin D deficiency has been associated with risk factors for cardiovascular disease, such as high blood pressure, diabetes, and inflammation." Previous studies have suggested that treatment with intravenous vitamin D can improve survival in patients on hemodialysis.

The new results suggest that treatment with oral activated vitamin D may also improve survival in patients with CKD who do not yet require dialysis. "Randomized clinical trials are needed to test the hypothesis that vitamin D therapy can improve cardiovascular health and survival in CKD," Dr. Kestenbaum adds. "Future studies should also examine the role of non-activated vitamin D, which is less expensive and less toxic."

The study has some important limitations, including a lack of data on other factors that may have affected survival in patients taking calcitriol. Also, since the study included mainly older, white men, the results may not apply to younger, more ethnically diverse populations with CKD.

Source: American Society of Nephrology

Explore further: Connection found between birth size and brain disorders

add to favorites email to friend print save as pdf

Related Stories

US judge fines HP $59 mn for bribing Russian officials

51 minutes ago

A judge on Thursday ordered US computer giant Hewlett-Packard to pay $58.8 million for bribing Russian government officials to win a big-money contract with the prosecutor general's office in that nation.

Solar storm heads Earth's way after double sun blasts

1 hour ago

Two big explosions on the surface of the sun will cause a moderate to strong geomagnetic storm on Earth in the coming days, possibly disrupting radio and satellite communications, scientists said Thursday.

US threatened Yahoo with huge fine over surveillance

2 hours ago

US authorities threatened to fine Yahoo $250,000 a day if it failed to comply with a secret surveillance program requiring it to hand over user data in the name of national security, court documents showed ...

Microbes evolve faster than ocean can disperse them

2 hours ago

Two Northeastern University researchers and their international colleagues have created an advanced model aimed at exploring the role of neutral evolution in the biogeographic distribution of ocean microbes.

Recommended for you

Connection found between birth size and brain disorders

1 hour ago

(Medical Xpress)—A trio of researchers has found what appears to be a clear connection between birth size and weight, and the two brain disorders, autism and schizophrenia. In their paper published in Proceedings of ...

A novel therapy for sepsis?

18 hours ago

A University of Tokyo research group has discovered that pentatraxin 3 (PTX3), a protein that helps the innate immune system target invaders such as bacteria and viruses, can reduce mortality of mice suffering ...

User comments : 0