scholarly journals Oral active vitamin D is associated with improved survival in hemodialysis patients

2008 ◽  
Vol 74 (8) ◽  
pp. 1070-1078 ◽  
Author(s):  
Manuel Naves-Díaz ◽  
Daniel Álvarez-Hernández ◽  
Jutta Passlick-Deetjen ◽  
Adrian Guinsburg ◽  
Cristina Marelli ◽  
...  
Keyword(s):  
Vitamin D ◽  
Hemodialysis Patients ◽  
Active Vitamin ◽  
Active Vitamin D

The Effect of Active Vitamin D Administration on Muscle Mass in Hemodialysis Patients

2013 ◽  
Vol 33 (11) ◽  
pp. 837-846 ◽  
Author(s):  
Atsushi Mori ◽  
Tomoya Nishino ◽  
Yoko Obata ◽  
Masayuki Nakazawa ◽  
Misaki Hirose ◽  
...  
Keyword(s):  
Vitamin D ◽  
Muscle Mass ◽  
Hemodialysis Patients ◽  
Active Vitamin ◽  
Active Vitamin D

MO796IMPACT OF ACTIVE VITAMIN D AND CALCIUM PREPARATION ON VASCULAR CALCIFICATION MARKERS IN HEMODIALYSIS PATIENTS WITH HYPOCALCEMIA INDUCED BY CALCIMIMETICS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Yusaku Hashimoto ◽  
Sawako Kato ◽  
Masato Tsuboi ◽  
Makoto Kuro-o ◽  
Yachiyo Kuwatsuka ◽  
...  
Keyword(s):  
Vitamin D ◽  
Treatment Group ◽  
Vascular Calcification ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Hemodialysis Patients ◽  
Active Vitamin ◽  
Oral Calcium ◽  
Active Vitamin D ◽  
Time Point

Abstract Background and Aims Recently, we demonstrated the efficacy of etelcalcetide for control of secondary hyperparathyroidism (SHPT) in the DUET trial; a 12-week multicenter, open-label, randomized (1:1:1), parallel-group study treated with etelcalcetide + active vitamin D (Group E+D), etelcalcetide + oral calcium preparation (Group E+Ca), or control groups (Group C) in 124 subjects undergoing maintenance hemodialysis. Moreover, we also showed that active vitamin D was useful in correcting hypocalcemia induced by calcimimetics, but the oral calcium preparation was superior for suppression of hyperphosphatemia. In this post hoc analysis, we evaluated vascular calcification markers, fibroblast growth factor 23 (FGF23) and calciprotein particles (CPPs), in patients using etelcalcetide (n = 77) extracted from the registrants of the DUET trial. Method Serum levels of FGF23 and CPPs were measured at baseline, 6 weeks and 12 weeks after start of the trial. Skewed data (FGF23 and CPPs) were transformed to natural logarithm to achieve normal distribution prior to statistical analysis. The changes in log CPPs and log FGF23 were estimated in a linear mixed model with each treatment group, time point, and interaction of the treatment group and time point as the fixed effects. We compared these changes between treatment the groups using a linear mixed model and also the Tukey-Kramer method to correct for multiplicity. Additionally, we exploratory examined the correlations among changes of FGF23, CPPs and other biomarkers related to bone mineral metabolisms, iPTH, Ca, P, and calcium-phosphate product, tested by Spearman’s rank correlation coefficient. Results The decreases at the 12-week time point after the trial start in log FGF23 were estimated -1.13 pg/mL in Group E+Ca and -0.10 pg/mL in Group E+D in a linear mixed model, respectively. Similarly, the decreases in CPPs were estimated -1.60 AU in Group E+Ca and -0.82 AU in Group E+D, respectively. Changes of both FGF23 (P = 0.017) and CPPs (P < 0.001) in Group E+Ca significantly decreased compared with those in in Group E+D by Tukey-Kramer multiple-comparison test at 12 weeks after the trial start, while both changes in CPPs and FGF23 could not reach the significant differences between two groups at 6 weeks after the trial start (Figure 1). Reductions in FGF23 positively correlated with reductions in calcium (ρ = 0.42, P < 0.01) and phosphate (ρ = 0.48, P < 0.01) at 6 weeks after the trial start, and in calcium (ρ = 0.30, P < 0.01) and phosphate (ρ =0.70, P < 0.01) at 12 weeks after 6 weeks of the trial start), but there was no correlation with reductions in iPTH at any time point. Reductions in CPPs positively correlated with reductions only in phosphate at 6 weeks after the trial start (ρ = 0.47, P < 0.01) and at 12 weeks after 6 weeks of the trial start (ρ = 0.54, P < 0.01). Conclusion In this analysis, vascular calcification markers were significantly decreased in Group E+Ca compared to those in Group E+D. Further studies should be needed, our study suggests that oral calcium preparation may have an advantage against vascular calcification rather than active vitamin D for the correction of hypocalcemia induced by etelcalcetide in hemodialysis patients with SHPT.

scholarly journals Mortality in Hemodialysis Patients with COVID-19, the Effect of Paricalcitol or Calcimimetics

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2559
Author(s):  
María Dolores Arenas Jimenez ◽  
Emilio González-Parra ◽  
Marta Riera ◽  
Abraham Rincón Bello ◽  
Ana López-Herradón ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mortality Rate ◽  
Secondary Hyperparathyroidism ◽  
Cox Regression ◽  
Serum Vitamin ◽  
Hemodialysis Patients ◽  
Active Vitamin ◽  
Cox Regression Analysis ◽  
Active Vitamin D ◽  
The Impact

Background. In COVID-19 patients, low serum vitamin D (VD) levels have been associated with severe acute respiratory failure and poor prognosis. In regular hemodialysis (HD) patients, there is VD deficiency and markedly reduced calcitriol levels, which may predispose them to worse outcomes of COVID-19 infection. Some hemodialysis patients receive treatment with drugs for secondary hyperparathyroidism, which have well known pleiotropic effects beyond mineral metabolism. The aim of this study was to evaluate the impact of VD status and the administration of active vitamin D medications, used to treat secondary hyperparathyroidism, on survival in a cohort of COVID-19 positive HD patients. Methods. A cross-sectional retrospective observational study was conducted from 12 March to 21 May 2020 in 288 HD patients with positive PCR for SARS-CoV2. Patients were from 52 different centers in Spain. Results. The percent of HD patients with COVID-19 was 6.1% (288 out of 4743). Mortality rate was 28.4% (81/285). Three patients were lost to follow-up. Serum 25(OH)D (calcidiol) level was 17.1 [10.6–27.5] ng/mL and was not significantly associated to mortality (OR 0.99 (0.97–1.01), p = 0.4). Patients receiving active vitamin D medications (16/94 (17%) vs. 65/191(34%), p = 0.003), including calcimimetics (4/49 (8.2%) vs. 77/236 (32.6%), p = 0.001), paricalcitol or calcimimetics (19/117 (16.2%) vs. 62/168 (36.9%); p < 0.001), and also those on both paricalcitol and calcimimetics, to treat secondary hyperparathyroidism (SHPTH) (1/26 (3.8%) vs. 80/259 (30.9%), p < 0.001) showed a lower mortality rate than patients receiving no treatment with either drug. Multivariate Cox regression analysis confirmed this increased survival. Conclusions. Our findings suggest that the use of paricalcitol, calcimimetics or the combination of both, seem to be associated with the improvement of survival in HD patients with COVID-19. No correlation was found between serum VD levels and prognosis or outcomes in HD patients with COVID-19. Prospective studies and clinical trials are needed to support these findings.

scholarly journals Calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroko Hashimoto ◽  
Satomi Shikuma ◽  
Shintaro Mandai ◽  
Susumu Adachi ◽  
Shinichi Uchida
Keyword(s):  
Vitamin D ◽  
Calcium Supplementation ◽  
Hemodialysis Patients ◽  
Phosphate Binders ◽  
Maintenance Hemodialysis ◽  
Active Vitamin ◽  
Mineral Density ◽  
Active Vitamin D ◽  
Dialysis Vintage ◽  
Osteoporosis Risk

AbstractLoss of bone mineral density (BMD) is a substantial risk of mortality in addition to fracture in hemodialysis patients. However, the factors affecting BMD are not fully determined. We conducted a single-center, cross-sectional study on 321 maintenance hemodialysis patients who underwent evaluation of femoral neck BMD using dual-energy X-ray absorptiometry from August 1, 2018, to July 31, 2019. We examined factors associated with osteoporosis defined by T-score of ≤  − 2.5, using logistic regression models. Median age of patients was 66 years, and 131 patients (41%) were diagnosed with osteoporosis. Older age, female, lower body mass index, diabetes mellitus, and higher Kt/V ratios were associated with higher osteoporosis risk. The only medication associated with lower osteoporosis risk was calcium-based phosphate binders (CBPBs) [odds ratio (OR), 0.41; 95% confidence interval (CI), 0.21–0.81]. In particular, CBPB reduced the osteoporosis risk within subgroups with dialysis vintage of ≥ 10 years, albumin level of < 3.5 mg/dL, active vitamin D analog use, and no proton pump inhibitor (PPI) use. In conclusion, CBPB use was associated with lower osteoporosis risk in hemodialysis patients. This effect might be partially attributable to calcium supplementation, given its higher impact in users of active vitamin D analogs or non-users of PPI, which modulate calcium absorption.

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