Related Experiment Videos
[Vitamin D and survival of hemodialysis patients]
Tetsuo Shoji1, Yoshiki Nishizawa
1Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine.
Abstract:
Vitamin D receptors are expressed not only in the classical target organs (bone, parathyroid glands, kidneys and intestine) but also in other non-classical targets including arteries, heart, immune system, endocrine organs, and nervous system. Therefore, the deficiency of active forms of vitamin D in uremia may explain various abnormalities in biological functions and survival disadvantage in this disease condition. Previous studies reported that treatment with vitamin D had beneficial effects on cardiac and immune functions in dialysis patients. A recent observational cohort study indicated that the mortality risk was different between the groups taking different types of vitamin D analogues. We found that patients on a low-dose oral alfacalcidol showed a significantly lower risk for cardiovascular death than those without vitamin D supplementation. Although these observations need further confirmation by randomized controlled studies, appropriate use of active forms of vitamin D may improve the outcomes of patients with chronic kidney disease.
Insights
Vitamin D deficiency in chronic kidney disease contributes to health issues. Low-dose alfacalcidol may reduce cardiovascular death risk in dialysis patients, warranting further study.
Area of Science:
- Endocrinology
- Nephrology
- Cardiovascular Medicine
Context:
- Vitamin D receptors are present in classical target organs and non-classical sites like arteries, heart, immune, endocrine, and nervous systems.
- Vitamin D deficiency in uremia can lead to diverse biological abnormalities and increased mortality.
- Previous research suggests vitamin D supplementation benefits cardiac and immune functions in dialysis patients.
Purpose:
- To investigate the association between different vitamin D analogues and mortality risk in dialysis patients.
- To evaluate the impact of low-dose oral alfacalcidol on cardiovascular death risk.
Summary:
- A recent observational cohort study analyzed mortality risks among dialysis patients using different vitamin D analogues.
- Patients receiving low-dose oral alfacalcidol demonstrated a significantly reduced risk of cardiovascular death compared to unsupplemented patients.
- These findings suggest a potential benefit of specific vitamin D analogues in managing cardiovascular outcomes in chronic kidney disease.
Impact:
- Appropriate use of active vitamin D forms may improve patient outcomes in chronic kidney disease.
- Further randomized controlled studies are needed to confirm these observational findings.
- Highlights the potential role of vitamin D in mitigating cardiovascular complications in uremic patients.
Related Concept Videos
Hemodialysis III: Nursing Management
Hemodialysis II: Procedure and Complications
Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Chronic Kidney Disease III: Interprofessional Care
Hemodialysis I: Introduction
Role of Skin in Vitamin D Synthesis
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin D3(cholecalciferol).