Vitamin D status and mortality of German hemodialysis patients.
OBJECTIVE
The goal was to analyze the link between blood levels of calcidiol and all-cause, cardiac and infectious diseases, and mortality due to cancer in hemodialysis patients.


METHODS
This study retrospectively evaluated a representative sub-cohort (n=6,518) of German hemodialysis patients from the incidence cohorts 1997-2006.


RESULTS
Most (58.8%) were found to be vitamin D deficient (25(OH)D<20 ng/ml), with 41.2% being severely deficient (25(OH)D<12.5 ng/ml). All-cause mortality risk more than doubled in patients with severe deficiency (adjusted odds ratio (aOR)=2.67; 95% confidence interval (CI)=2.30-3.10; p<0.0001). Comparable data were obtained for mortality from cardiac disease (aOR=1.57; 95% CI=1.30-1.88; p<0.0001), infectious disease (aOR=1.48; 95% CI=1.15-1.90; p=0.0026), and cancer (aOR=1.51; 95% CI=1.09-2.08; p=0.0121), respectively.


CONCLUSIONS
These data highlight the need to ensure primarily adequate 25(OH)D levels in dialysis patients for an advantage of survival.
KfH Nephrological Center Moabit, Turmstr. 20A, 10559 Berlin, Germany. rolfdieter.krause@kfh-dialyse.de
Rolfdieter
R
Krause
Hans-Jürgen
HJ
Schober-Halstenberg
Günter
G
Edenharter
Kirsten
K
Haas
Heinz Jürgen
HJ
Roth
Ulrich
U
Frei
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002112:Calcifediol / Q000097:blood*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D003141:Communicable Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*; D011379:Prognosis; D006435:Renal Dialysis / Q000009:adverse effects* / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D044465:White People; D055815:Young Adult
D002112:Calcifediol