The use of activated vitamin D and risks of hospitalization for infection and amputation in incident hemodialysis patients in Taiwan: a nationwide population-based cohort study
BMC Nephrology volume 21, Article number: 331 (2020)
Jo-Yen Chao, Chung-Yi Li, Ming-Cheng Wang & Yea-Huei Kao Yang
- Poor kidney ==> poor conversion of Vitamin D
- Very poor kidney ==> Hemodialysis (filtering of blood)
- Some Hemodialysis devices filter out Vitamin D
- Some Hemodialysis centers used to restore Vitamin D
- Hemodialysis deaths less likely if take vitamin D, especially if highest dose vitamin D – Nov 2018
- Dialysis patients 23 percent more likely to live if had just 10 ng more Vitamin D – meta-analysis Feb 2018
- Dialysis patients who added Vitamin D were 41 percent less likely to get infection – Meta-analysis July 2018
- Those Dialysis patients with low vitamin D were 75% more likely to die – July 2013
- Peritoneal dialysis probably consumes a lot more vitamin D than haemodialysis
- Vitamin D appears essential to survive many critical illnesses - review Oct 2018
- Chronic kidney treatment by Vitamin D lacks consensus: type, how much – Sept 2018
- Hypothesis: Magnesium might prevent and treat Chronic Kidney Disease – April 2018
- Majority of blacks on dialysis were vitamin D deficient - March 2010
Kidney category starts with
Kidney category listing hassee also Overview Kidney and vitamin D
Search Vitamin D Life for dialysis OR haemodialysis 878 items not in PDF as of Aug 2020
Search Vitamin D Life for kidney transplant 798 items as of June 2019
"Chronic Kidney Disease" OR CKD 874 items as of Jan 2018
Kidney Intervention trials using Vitamin D:
- Chronic Kidney Disease (stage 3) slowed by 30 ng of Vitamin D and Calcitriol – Dec 2019
- Diabetic nephropathy (Kidney) treated by 50,000 IU of vitamin D weekly – RCT Jan 2019
- Hemodialysis patients (CKD) helped by weekly 50,000 IU of vitamin D – Jan 2017
- Kidney disease helped by active or high dose Vitamin D - Feb 2014
- Peritoneal Dialysis nicely treated by active vitamin D – July 2013
- 7100 IU (50000 weekly) restored vitamin D levels for those with Chronic Kidney Disease – July 2012
- Chronic Kidney Disease reduced with 3600 IU vitamin D (50000 twice a month)– RCT Aug 2012
- Overview Kidney and vitamin D
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
194 items Download the PDF from Vitamin D Life
Statistically significant: amputation and infection
Note: veritcal axis variesBackground
Hemodialysis patients have a high risk of mortality. The most common causes of death are cardiovascular disease and infection. The potential hazard or benefit associated with vitamin D use and cardiovascular or infection outcome is poorly characterized.Methods
We conducted a retrospective observational cohort study by recruiting 52,757 patients older than 20 years from Taiwan National Health Insurance Research Database (NHIRD) who initiated maintenance hemodialysis between 2001 and 2009. Patients who were prescribed activated vitamin D before the 360th day from hemodialysis initiation were defined as vitamin D users. The primary outcome of interest includes occurrence of acute myocardial infarction (AMI), ischemic stroke, lower limb amputation, and hospitalization for infection, respectively, while death events are treated as competing events. We conducted competing risk analysis using subdistribution hazard regression model to estimate subdistribution hazard ratios (SHRs) in relation to various outcomes.Results
During the median follow-up of 1019 days, the vitamin D users had a lower crude mortality rate, lower incidences of AMI, ischemic stroke, amputation, and hospitalization for infection compared with non-users. Taking into consideration competing events of death, vitamin D users were associated with a lower hazard of lower limb amputation (SHR 0.84 [95% CI, 0.74–0.96]) and hospitalization for infection (SHR 0.90 [95% CI, 0.87–0.94]), but not AMI or ischemic stroke, after adjustment for potential confounders. Subgroup analyses and dose response evaluation both showed a consistent association of activated vitamin D treatment with decreased risk of amputation and infection.Conclusion
The findings suggest that therapeutic activated vitamin D use in hemodialysis patients may be beneficial for decreasing infection events and amputation, of which the latter is a complication of peripheral vascular disease, rather than reducing major atherosclerotic cardiovascular events such as AMI or ischemic stroke.Hemodialysis with low vitamin D increases risk of 2 health problems by 10 percent – Aug 2020Printer Friendly PDF this page! Follow this page for updates292 visitors, last modified 06 Aug, 2020, This page is in the following categories (# of items in each category)