Relation of oral 1alpha-hydroxy vitamin D3 to the progression of aortic arch calcification in hemodialysis patients.
The role of decreased active vitamin D levels on vascular calcification has not been elucidated in hemodialysis (HD) patients. The aim of the present study was to evaluate the relationship between progression of aortic arch calcification (AoAC) and prescribed dose of 1alpha-hydroxy vitamin D. The enrolled study subjects were 65 (40 men and 25 women) HD patients. Calcification of the aortic arch was semiquantitatively estimated with a score (AoACS) on plain chest radiology. Change in AoACS (DeltaAoACS) was obtained by subtracting the baseline AoACS value from the follow-up AoACS value. The second assessment was performed from 2 years after the first determination. The nonprogressors (63.2 +/- 14.5 years) were significantly younger than the progressors (68.2 +/- 10.8 years) (P = 0.0419). In addition, prescribed dose of 1alpha-hydroxy vitamin D3 was significantly higher in the nonprogressors (125.5 +/- 109.1 microg) than progressors (84.8 +/- 81.1 microg) (P = 0.0371). Multiple regression analysis revealed prescribed dose of 1alpha-hydroxy vitamin D(3) (beta value = -0.324, P = 0.0051) as well as DBP (beta value = -0.418, P = 0.007), serum levels of P (beta value = 0.333, P = 0.006) and C-reactive protein (beta value = 0.237, P = 0.0048) to be significant independent determinants of DeltaAoACS. In conclusion, the evaluation of AoACS on chest radiography is a very simple tool in HD patients. Active vitamin D therapy seems to protect patients from developing vascular calcification.
Ogawa
Tetsuya
T
Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. togawa@kc.twmu.ac.jp
Ishida
Hideki
H
Akamatsu
Mayuko
M
Matsuda
Nami
N
Fujiu
Ayuko
A
Ito
Kyoko
K
Ando
Yoshitaka
Y
Nitta
Kosaku
K
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000187:drug effects*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage*; D007674:Kidney Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D006435:Renal Dialysis; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage*; D055815:Young Adult
D006887:Hydroxycholecalciferols; D014815:Vitamins; C008088:alfacalcidol