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[The association between vitamin D/calcium deficiency and cardiovascular events.]

Takayuki Hamano1, Sayoko Yonemoto2

  • 1Department of Inter-Organ Communication Research in Kidney Disease, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Clinical Calcium
|January 26, 2019
PubMed

Insights

Severe hypocalcemia can cause heart failure, a condition known as hypocalcemic cardiomyopathy. Active vitamin D treatment did not reduce cardiovascular events in hemodialysis patients with low parathyroid hormone levels.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Extreme hypocalcemia, often due to vitamin D and calcium deficiency, is linked to heart failure, termed hypocalcemic cardiomyopathy.
  • This condition affects various age groups, including the elderly and infants.
  • Hypocalcemia in chronic kidney disease (CKD) and heart failure patients predicts poorer outcomes.

Purpose of the Study:

  • To evaluate the efficacy of active vitamin D analogues in reducing cardiovascular events in CKD patients.
  • To investigate whether the benefits of vitamin D therapy are restricted to patients with elevated parathyroid hormone (PTH) levels.

Main Methods:

  • Analysis of observational studies and a randomized controlled trial (J-DAVID study).
  • Focus on hemodialysis patients with varying parathyroid hormone (PTH) levels.

Main Results:

  • Observational studies suggest active vitamin D reduces cardiovascular events, but indication biases exist.
  • The J-DAVID randomized trial found no reduction in cardiovascular events with alfacalcidol in hemodialysis patients with intact PTH < 180 pg/mL.

Conclusions:

  • The cardiovascular benefits of active vitamin D analogues may be limited to CKD patients with high PTH levels.
  • Alfacalcidol did not demonstrate efficacy in preventing cardiovascular events in hemodialysis patients with PTH < 180 pg/mL.

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