Vitamin D might reduce risk of death in CKD patients05/07/2008
WASHINGTON—Vitamin D treatment for patients with moderate to severe chronic kidney disease might reduce their risk of death by more than 25 percent, according to a study to be published in the August Journal of the American Society of Nephrology.
Many CKD patients take an oral form of activated vitamin D called calcitriol to treat elevated levels of parathyroid hormone, according to background information. Dr. Bryan Kestenbaum, of the University of Washington, and one of the study’s co-authors said, “Although activated vitamin D is known to influence many biological processes, previous clinical knowledge is limited to its effect on parathyroid hormone levels.”
The 1,418 patients in the study had stage 3 to 4 CKD and high parathyroid hormone levels, which weakens bones. One group of patients were treated with calcitriol, the other group did not receive the drug.
After a two-year follow up, mortality rates between the two groups were compared. The results were adjusted for age, kidney function, parathyroid hormone levels, other illnesses and other medications.
Researchers found patients talking calcitriol had a 26 percent lower risk of death. In addition, patient taking calcitriol were likely to develop end-stage renal disease and need dialysis, according to the study.
In all, calcitriol treatment reduced the risk of death and dialysis by 20 percent, according to the study. In addition, the reduced mortality risk associated with taking calcitriol was independent of its effect on parathyroid hormone levels.
The study, however, lacked data on other factors that could have affected survival in patients taking calcitriol. The study also may not apply to younger, ethnically diverse CKD patients since most of the patients studied were older, white men.
“Randomized clinical trials are needed to test the hypothesis that vitamin D therapy can improve cardiovascular health and survival in CKD,” said Kestenbaum, who receives consulting fees from Abbott, Shire and grant support from Amgen. “Future studies should also examine the role of non-activated vitamin D, which is less expensive and toxic.”
http://www.renalbusiness.com/hotnews/vitamin-d-reduced-ckd-mortality-risk.html
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