Treatment with paricalcitol and/or calcimimetics is associated with improved survival in patients with COVID-19 receiving maintenance hemodialysis (HD), according to a recent study.
Investigators found no correlation between serum vitamin D levels and prognosis or outcomes in patients with COVID-19 receiving HD.In a cross-sectional study, 288 of 4743 Spanish patients (6.1%) on HD had positive PCR tests for SARS-CoV-2 from March 12 to May 21, 2020. Of these, 81 (28.4%) ultimately died. Serum 25(OH)D (calcidiol) levels showed no significant relationships with hospitalization, ICU admission, need for mechanical ventilation, or mortality, María Dolores Arenas Jimenez, MD, of Hospital del Mar in Barcelona, Spain, and colleagues reported in Nutrients. Patients taking active vitamin D (paricalcitol) or calcimimetics to treat secondary hyperparathyroidism (SHPT), however, had significant 50% and 67% lower mortality risks, respectively, compared with patients not taking these drugs. Higher serum albumin was associated with a 33% lower death risk. A more than 2-fold higher death risk was found among patients older than 70 years compared with those aged 70 years or younger. Patients with elevated C-reactive protein levels higher than 24 mg/dL had a significant 2.4-fold increased risk for death compared with those who had levels less than 5.6 mg/dL.
“Our findings suggest that the use of paricalcitol, calcimimetics or the combination of both, seem to be associated with the improvement of survival in HD patients with COVID-19,” Dr Jimenez’s team stated.
Phosphate (4.1 mg/dL), calcium (8.8 mg/dL) and parathyroid hormone (240 pg/dL) levels were all within target range indicating control of mineral bone disorder in this cohort. The investigators noted that “calcimimetics and paricalcitol have well known pleiotropic effects beyond mineral metabolism that may be of value in the current scenario of extreme mortality in this population.”
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Arenas Jimenez MD, González-Parra E, Riera M, et al. Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics. Nutrients. Published online on July 26, 2021. 13(8):2559. doi:10.3390/nu13082559