Vitamin D Replacement May Lower CV Event Risk

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LAS VEGAS—Treatment of 25-hydroxyvitamin D (25(OH)D) deficiency with ergocalciferol in patients with moderate chronic kidney disease (CKD) is associated with a significant reduction in the risk of cardiovascular (CV) events, data show.

Researchers led by Kunal Chaudhary, MD, and Anand Chockalingam, MD, of Harry S. Truman Memorial Veterans Hospital and the University of Missouri in Columbia, Mo., reviewed data from the medical records of all veterans who had CKD stage 3 and 4 and had 25(OH)D levels determined.

The study included 126 men with 25(OH)D deficiency, defined as a serum level below 30 pg/mL. The investigators defined successful 25(OH)D replacement as a prescription of ergocalciferol sufficient to raise serum 25(OH)D by 25% from baseline within six months. Ninety patients met this definition and were considered the treatment group. The other 36 patients were considered as untreated controls.

During a median follow-up of 27.2 months, 44% of controls had CV events compared with only 21% of patients in the treatment group, investigators reported at the National Kidney Foundation's Spring Clinical Meetings. After adjusting for multiple variables, including initial parathyroid hormone level, age, statin use, history of CV disease, and glomerular filtration rate, subjects with successful 25(OH)D replacement had a 63% decreased risk of CV events.

Additionally, data showed that overall and disease-specific survival were significantly lower in the untreated group.

Although the findings are promising, this is a small retrospective study, Dr. Chockalingam pointed out. Although recent studies show that vitamin D supplementation in the general population does not appear to reduce cardiovascular event risk, “diagnosing and treating vitamin D deficiency in high-risk populations might be beneficial and needs to be explored in future studies,” Dr. Chockalingam said.

At the university, Dr. Chockalingam is Assistant Professor of Medicine in the Division of Cardiovascular Medicine and Dr. Chaudhary is Associate Professor of Medicine in the Department of Nephrology. Dr. Chaudhary also is chief of nephrology at the veterans' hospital.

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