Peritoneal Dialysis nicely treated by active vitamin D – July 2013

Treatment with Oral Active Vitamin D Is Associated with Decreased Risk of Peritonitis and Improved Survival in Patients on Peritoneal Dialysis

Chart was created from study data

PLOS One 2013DOI: 10.1371/journal.pone.0067836
Julia Kerschbaum, Andreas Vychytil, Karl Lhotta, Friedrich C. Prischl, Martin Wiesholzer, Veronika Machhold-Fabrizii, Gertrude Kopriva-Altfahrt, Christoph Schwarz, Peter Balcke, Rainer Oberbauer, Reinhard Kramar, Paul König, Michael Rudnicki mail

Peritonitis is a major complication of peritoneal dialysis (PD) being associated with hospitalization, catheter loss, technique failure, and increased mortality. Data on incidence rates and risk factors for peritonitis episodes vary between centers. In seven Austrian PD units clinical and laboratory data on each peritonitis episode were collected from all patients (n = 726) who performed PD between January 2000 and December 2009. The peritonitis incidence rate was 0.32 episodes/patient-year. In a multivariate analysis the risk of peritonitis was decreased by 57% in patients treated with oral active vitamin D (HR 0.43; 95% CI 0.28–0.64). Renal disease classified as “other or unknown” (HR 1.65; 95% CI 1.08–2.53) and serum albumin <3500 mg/dl (HR 1.49; 95% CI 1.04–2.15) were also associated with an increased risk of peritonitis. Albumin levels <3500 mg/dl (HR 1.89; 95% CI 1.13–3.17), age (HR 1.06 per year; 95% CI 1.03–1.09), and cardiomyopathy (HR 3.01; 95% CI 1.62–5.59) were associated with increased mortality, whereas treatment with oral active vitamin D was associated with a significantly lower risk of death (HR 0.46; 95% CI 0.27–0.81). In this retrospective multi-center study we identified several factors being related to increased risk of peritonitis in PD patients. Treatment with oral active vitamin D was identified as being independently associated with decreased risk of peritonitis, and decreased all-cause mortality in PD patients.

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See also Vitamin D Life

• Peritoneal dialysis probably consumes a lot more vitamin D than haemodialysis
• Kidney Dialysis clinics reluctant to add vitamin D treatment as they are not reimbursed – Oct 2012
• Search Vitamin D Life for dialysis OR haemodialysis 309 items as of Feb 2015
• Dialysis patients need real vitamin D – Editorial July 2013
• Overview Kidney and vitamin D contains the following summary
• FACT: Kidney is the primary way to activate vitamin D
• FACT: When the Kidney has problems, there is less active vitamin D (Calcitriol) for the body
• FACT: When the Kidney has problems, there is increased death due to many factors - many of which are associated with lack of Calcitriol
• FACT: There are many on-going intervention clinical trials trying to determine how much of what kind of vitamin D is needed to treat the problem
• FACT: One Randomized Controlled Trial has proven that Vitamin D treats CKD
• FACT: Taking extra Vitamin D, in various forms, does not cause health problems - even if poor kidney
• Suggestion: Increase vitamin D getting into body now - and increase co-factors so that the vitamin D can be better used
    Sun, UV lamp, Vitamin D supplement - probably > 5,000 IU,
  Calcitriol - which bypasses the need for the kidney to activate vitamin D
    Problems with Calcitriol however: typically only lasts for a few hours, also, possible complications
      Update: Pre-cursor of active vitamin D made from plants is better than calcitriol – Sept 2012
• Category Kidney and Vitamin D contains 193 items