title: Treatment of 25-OH vitamin D deficiency in older men with chronic kidney disease stages 3 and 4 is associated with reduction in cardiovascular events.
abstract: Observational studies in healthy people suggest an inverse relationship between serum 25-hydroxyvitamin D (25OHD) levels and cardiovascular (CV) mortality. Treating vitamin D deficiency in patients with moderate chronic kidney disease (CKD) may reduce CV events in this high-risk population. Study data were abstracted from Harry S. Truman Memorial Veterans Hospital electronic medical record system. The medical records of all veterans who had CKD stages 3 and 4 and had 25OHD levels determined from April 2006 to September 2007 were reviewed. Patients with 25OHD deficiency, serum level <30 ng/mL, were included (N = 126, all men, mean age = 70 years). Successful 25OHD replacement was defined as prescription of ergocalciferol sufficient to increase serum 25OHD level by 25% from baseline within 6 months (treatment group, n = 90). Otherwise patients were considered as untreated controls (n = 36). The date when the 25OHD level was drawn was considered as the date of inclusion. All the patients were followed up from the date of inclusion until July 2009 to capture CV events prospectively. During mean follow-up of 27.2 months, 44% of the controls had CV events, whereas only 21% of the patients in the treatment group had CV events (P = 0.001). In multivariate logistic regression analysis, adjusting for CV disease predictors age, initial parathyroid hormone level, statin use, history of CV disease, and glomerular filtration rate, the estimated odds ratio for 25OHD replacement status was 0.37 (95% confidence interval: 0.14-1.0). Treatment of 25OHD deficiency with ergocalciferol in patients with moderate CKD is associated with significant reduction in CV events.
authors.affiliation: 1Harry S. Truman Memorial Veterans' Hospital, Columbia, MO; and 2Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO.
authors.forename: Anton
authors.initials: A
authors.lastname: Lishmanov
authors.forename: Smrita
authors.initials: S
authors.lastname: Dorairajan
authors.forename: Youngju
authors.initials: Y
authors.lastname: Pak
authors.forename: Kunal
authors.initials: K
authors.lastname: Chaudhary
authors.forename: Anand
authors.initials: A
authors.lastname: Chockalingam
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D015897:Comorbidity; D057286:Electronic Health Records; D004872:Ergocalciferols / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology*; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000188:drug therapy / Q000453:epidemiology*; D014815:Vitamins / Q000008:administration & dosage
chemical_list: D004872:Ergocalciferols; D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D