Patients who have vitamin D deficiency at the start of dialysis are at increased risk of death and hospitalization, according to a new study.
The study, which included 256 patients new to either hemodialysis or peritoneal dialysis and who had a mean follow-up of 3.8 years, showed that patients with concentrations of 25-hydroxyvitamin D (25-OH vitamin D) in the lowest and middle tertiles at the start of dialysis had a 75% and 55% increased risk of death, respectively, and a 76% and 29% increased risk of hospitalization compared with those in the highest tertile, after adjusting for confounding factors.
In addition, each 10-year increment in age was associated with a 49% increased risk of death and a 22% increased risk of hospitalization, Shuchi Anand, MD, of the Stanford University School of Medicine in Palo Alto, Calif., and colleagues reported in the Journal of Renal Nutrition (2013;23:422-427).
The lowest, middle, and highest tertiles of 25-OH vitamin D were levels less than 10.6, 10.6-15.5, and greater than 15.5 ng/mL, respectively. Vitamin D deficiency is defined as a serum concentration less than 20 ng/mL, the researchers noted.
“Our study adds to the current observational literature demonstrating that patients with severe 25-OH vitamin D deficiency have poorer survival,” the researchers concluded. “It is not yet clear whether measurement of 25-OH vitamin D concentrations and supplementation in deficient patients will improve survival or reduce hospitalization or other adverse health outcomes.”
The patients, who participated in the Comprehensive Dialysis Study, had a mean age of 62 years.