title: Oral active vitamin D is associated with improved survival in hemodialysis patients.
abstract: Injection of active vitamin D is associated with better survival of patients receiving chronic hemodialysis. Since in many countries oral active vitamin D administration is the most common form of treatment for secondary hyperparathyroidism we determined the survival benefit of oral active vitamin D in hemodialysis patients from six Latin America countries (FME Register as part of the CORES study) followed for a median of 16 months. Time-dependent Cox regression models, after adjustment for potential confounders, showed that the 7,203 patients who received oral active vitamin D had significant reductions in overall, cardiovascular, infectious and neoplastic mortality compared to the 8,801 patients that had not received vitamin D. Stratified analyses found a survival advantage in the group that had received oral active vitamin D in 36 of the 37 strata studied including that with the highest levels of serum calcium, phosphorus and parathyroid hormone. The survival benefit of oral active vitamin D was seen in those patients receiving mean daily doses of less than 1 microg with the highest reduction associated with the lowest dose. Our study shows that hemodialysis patients receiving oral active vitamin D had a survival advantage inversely related to the vitamin dose.
authors.affiliation: Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Instituto Reina Sofía de Investigación, REDinREN del ISCIII, Universidad de Oviedo, Julián Claveria s/n, 33006 Oviedo, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Naves-Díaz
authors.forename: Daniel
authors.initials: D
authors.lastname: Alvarez-Hernández
authors.forename: Jutta
authors.initials: J
authors.lastname: Passlick-Deetjen
authors.forename: Adrian
authors.initials: A
authors.lastname: Guinsburg
authors.forename: Cristina
authors.initials: C
authors.lastname: Marelli
authors.forename: Diego
authors.initials: D
authors.lastname: Rodriguez-Puyol
authors.forename: Jorge B
authors.initials: JB
authors.lastname: Cannata-Andía
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000401:mortality / Q000628:therapy*; D007843:Latin America; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D012042:Registries; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; D002118:Calcium