title: Serum 25-Hydroxyvitamin D Level Could Predict the Risk for Peritoneal Dialysis-Associated Peritonitis.
abstract: ♦
  
  
  BACKGROUND
  As an immune system regulator, vitamin D is commonly deficient among patients on peritoneal dialysis (PD), which may contribute to their impaired immune function and increased risk for PD-related peritonitis. In this study, we aimed to investigate whether vitamin D deficiency could predict the risk of peritonitis in a prospective cohort of patients on PD. ♦
  
  
  METHODS
  We collected 346 prevalent and incident PD patients from 2 hospitals. Baseline demographic data and clinical characteristics were recorded. Serum 25-hydroxyvitamin D (25[OH]D) was measured at baseline and prior to peritonitis. The mean doses of oral active vitamin D used during the study period were also recorded. The outcome was the occurrence of peritonitis. ♦
  
  
  RESULTS
  The mean age of patients and duration of PD were 58.95 ± 13.67 years and 28.45 (15.04 - 53.37) months, respectively. Baseline 25(OH)D level was 16.15 (12.13 - 21.16) nmol/L, which was closely associated with diabetic status, longer PD duration, malnutrition, and inflammation. Baseline serum 25(OH)D predicted the occurrence of peritonitis independently of active vitamin D supplementation with a hazard ratio (HR) of 0.94 (95% confidence interval [CI] 0.90 - 0.98) after adjusting for recognized confounders (age, gender, dialysis duration, diabetes, albumin, residual renal function, and history of peritonitis). Compared to the low tertile, middle and high 25(OH)D level tertiles were associated with a decreased risk for peritonitis with HRs of 0.54 (95% CI 0.31 - 0.94) and 0.39 (95% CI 0.20 - 0.75), respectively. ♦
  
  
  CONCLUSIONS
  Vitamin D deficiency evaluated by serum 25(OH)D rather than active vitamin D supplementation is closely associated with a higher risk of peritonitis.
authors.affiliation: Renal Division, Department of Medicine, Institute of Nephrology, Peking University, Beijing, China.
authors.forename: Hai-Chen
authors.initials: HC
authors.lastname: Pi
authors.affiliation: Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China.
authors.forename: Ye-Ping
authors.initials: YP
authors.lastname: Ren
authors.affiliation: Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Renal Division, Department of Medicine, Institute of Nephrology, Peking University, Beijing, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Xu
authors.affiliation: Renal Division, Department of Medicine, Institute of Nephrology, Peking University, Beijing, China dongjie@medmail.com.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Dong
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000097:blood* / Q000209:etiology*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: 25(OH)D; Vitamin D; peritoneal dialysis; peritonitis