Active vitamin D use does not reduce fracture risk independent of parathyroid hormone (PTH) control, investigators reported at Kidney Week 2022, the annual meeting of the American Society of Nephrology.
Among 41,677 patients receiving hemodialysis in the 2005-2018 DOPPS, 55% were prescribed active vitamin D, ranging from a low of 25% of patients in France to a high of 72% of patients in Sweden.
Event rates were 0.024 for any fracture and 0.010 for hip fracture per patient-year. The risks for any fracture and hip fracture did not differ significantly between patients prescribed and not prescribed active vitamin D, Hirotaka Komaba, MD, PhD, of Tokai University School of Medicine in Isehara, Japan, and colleagues reported. Risk of any fracture and hip fracture also did not differ significantly among dialysis facilities prescribing active vitamin D to less than 40% vs 40% to 70% of patients. The investigators adjusted models for demographics, dialysis vintage, comorbidities, laboratory values, PTH, phosphate binder type, and calcimimetic use.
“Our results do not suggest a PTH-independent benefit of active vitamin D in fracture prevention,” Dr Komaba’s team concluded. “Further research is needed to determine the role of active vitamin D beyond PTH control.”
Disclosure: This research was supported by Kyowa Kirin. Please see the original reference for a full list of disclosures.
Komaba H, Zhao J, Karaboyas A, et al. Active vitamin D use and fractures in hemodialysis patients: Results from the International DOPPS. Presented at: Kidney Week 2022; November 3-6, Orlando, Florida. Poster SA-PO184.