Mortality rates do not differ among patients prescribed various vitamin D agents

Area of Science:

• Nephrology
• Pharmacology
• Clinical Research

Background:

• Limited research exists on oral vitamin D formulations' impact on peritoneal dialysis (PD) patient outcomes.
• This study addresses the gap by comparing mortality rates across three common vitamin D agents in PD patients.

Purpose of the Study:

• To compare mortality rates associated with different oral vitamin D formulations in patients undergoing peritoneal dialysis.
• To investigate the clinical outcomes of calcitriol, paricalcitol, and doxercalciferol use in this specific patient group.

Main Methods:

• A retrospective analysis of 2 years of oral medication records from a large US dialysis organization.
• Identified 1,707 prevalent PD patients prescribed primarily one of three vitamin D agents: calcitriol, paricalcitol, or doxercalciferol.
• Assessed mortality rates, adjusting for patient demographics and comorbidities using Cox proportional hazards models.

Main Results:

• Calcitriol prescription was associated with a numerically lower mortality rate (9.33 deaths/100 patient-years) compared to doxercalciferol (12.20) and paricalcitol (12.27).
• These observed differences in mortality rates were not statistically significant.
• Adjusted analyses also revealed no statistically significant differences in mortality among the groups.

Conclusions:

• No significant difference in mortality was observed among peritoneal dialysis patients using calcitriol, doxercalciferol, or paricalcitol.
• Instrumental variable analyses supported the conclusion of no significant mortality difference between these common oral vitamin D formulations in the studied PD population.