title: Active vitamin D and acute respiratory infections in dialysis patients.
abstract: OBJECTIVE
  Vitamin D has gained attention for its pleiotropic effects in areas other than bone metabolism, and the effects of vitamin D in preventing respiratory infections have been reported as one of its immunomodulating properties. This study assessed the preventive effect of vitamin D receptor activator (VDRA) on respiratory infections in dialysis patients.
  
  
  METHODS
  Maintained Japanese hemodialysis patients (n = 508) were observed for 5 years, and the incidence of hospitalization during this period because of acute respiratory infection (ARI) was recorded.
  
  
  RESULTS
  Of the 508 patients, 212 had taken oral VDRA at the start of the study, whereas 296 patients had not received it. During the 5-year follow-up period, 57 patients were hospitalized because of ARIs. Kaplan-Meier analysis revealed that the incidence of hospitalization because of respiratory infection was significantly lower in patients who had been treated with VDRA compared with patients who had not (log rank test; P = 0.02). The multivariate Cox proportional hazards model demonstrated that the patients who had taken oral VDRA were at a significantly lower risk of hospitalization because of respiratory disease (hazard ratio 0.47, 95% confidence interval 0.25 to 0.90).
  
  
  CONCLUSIONS
  The findings of this study suggest that the administration of oral VDRA has a preventive effect on the incidence of ARIs in dialysis patients.
authors: Department of Internal Medicine, Inoue Hospital, Tokyo, Japan.
authors: Yoshihiro
authors: Y
authors: Tsujimoto
authors: Hideki
authors: H
authors: Tahara
authors: Tetsuo
authors: T
authors: Shoji
authors: Masanori
authors: M
authors: Emoto
authors: Hidenori
authors: H
authors: Koyama
authors: Eiji
authors: E
authors: Ishimura
authors: Tsutomu
authors: T
authors: Tabata
authors: Yoshiki
authors: Y
authors: Nishizawa
authors: Masaaki
authors: M
authors: Inaba
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