Oral Active Vitamin D Cuts Mortality
Hemodialysis patients who receive oral active vitamin D may have a survival advantage compared with those who do not take the vitamin, according to researchers.
Jorge B. Cannata-Andía, MD, of the Hospital Universitario Central de Asturias in Oviedo, Spain, and colleagues studied 16,004 hemodialysis patients in six Latin American countries (Venezuela, Argentina, Mexico, Brazil, Chile, and Colombia). Of these, 7,203 received oral active vitamin D and 8,801 did not. The patients had a median follow-up of 16 months; some had more than four years of follow-up.
Compared with patients who did not receive oral active vitamin D, those who did had an adjusted 45% lower overall mortality risk, the investigators reported in Kidney International (2008;74:1070-1078). The vitamin D group also had a 45%, 48%, and 47% decreased risk of death from cardiovascular, infectious, and neoplastic causes.
The survival benefit of oral active vitamin D was observed in patients receiving mean daily doses of less than 1 µg, with the highest reduction associated with the lowest doses. Mean daily doses lower than 0.25 and 0.25-0.50 µg significantly reduced mortality risk by 55% and 60%, respectively, compared with patients not taking oral active vitamin D. The researchers observed no significant decrease in mortality risk among patients receiving mean daily doses of 0.51-1.0 or greater than 1 µg.
The association of oral active vitamin D use with reduced mortality risk did not vary by country even though mortality rates did, according to the investigators.