Document Detail

Serum 25-hydroxyvitamin D status and cardiovascular outcomes in chronic peritoneal dialysis patients: a 3-y prospective cohort study.
MedLine Citation:
PMID:  18541550     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients with kidney disease are at high risk of developing 25-hydroxyvitamin D [25(OH)D] deficiency. OBJECTIVE: We studied the association between serum 25(OH)D status and clinical outcomes of chronic peritoneal dialysis patients. DESIGN: We measured serum 25(OH)D concentrations in 230 prevalent peritoneal dialysis patients and then followed these patients prospectively for 3 y or until death. RESULTS: Serum 25(OH)D was deficient or insufficient (ie, <75 nmol/L) in 87% of the patients. Adjusting for clinical and demographic factors, every 1-unit increase in log-transformed serum 25(OH)D was associated with a 44% reduction in the hazard of fatal or nonfatal cardiovascular events (95% CI: 0.35, 0.91; P = 0.018). However, the association was gradually lost when additional adjustment was made in a stepwise fashion for residual glomerular filtration rate (P = 0.078) and echocardiographic measures (P = 0.39). Kaplan-Meier estimates showed a significantly greater fatal or nonfatal cardiovascular event-free survival probability among patients with serum 25(OH)D > 45.7 nmol/L (median) than among patients with concentrations <or= 45.7 nmol/L (P = 0.004). In addition, patients with 25(OH)D > 45.7 nmol/L had a significantly higher cardiovascular event-free survival probability than did patients with 25(OH)D <or= 45.7 nmol/L in the stratified analysis for patients with left ventricular mass index less than the median (P = 0.013) or normal systolic function (P = 0.005). CONCLUSIONS: A lower serum 25(OH)D concentration was associated with an increased risk of cardiovascular events in chronic peritoneal dialysis patients. Furthermore, serum 25(OH)D status appeared to show a differential influence on the cardiovascular outcomes of peritoneal dialysis patients depending on the degree of left ventricular hypertrophy and systolic dysfunction.
Angela Yee-Moon Wang; Christopher Wai-Kei Lam; John E Sanderson; Mei Wang; Iris Hiu-Shuen Chan; Siu-Fai Lui; Mandy Man-Mei Sea; Jean Woo
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  87     ISSN:  1938-3207     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-10     Completed Date:  2008-08-01     Revised Date:  2009-05-15    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1631-8     Citation Subset:  AIM; IM    
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
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MeSH Terms
Cardiovascular Physiological Phenomena*
Cohort Studies
Diabetic Nephropathies / therapy
Kidney Failure, Chronic / therapy
Middle Aged
Patient Selection
Peritoneal Dialysis* / adverse effects
Prospective Studies
Survival Analysis
Treatment Outcome
Ventricular Function, Left
Vitamin D / analogs & derivatives*,  blood
Vitamin D Deficiency / etiology,  prevention & control
Reg. No./Substance:
1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D
Comment In:
Am J Clin Nutr. 2009 Jan;89(1):436; author reply 436-8   [PMID:  19056594 ]

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