AsianScientist (Dec. 26, 2018) – Although patients with chronic kidney disease have lower levels of vitamin D, supplementing their dialysis treatments with vitamin D did not reduce their risk of death, researchers report in a study published in JAMA.
“Treatment with active vitamin D did not decrease cardiovascular events in kidney patients undergoing hemodialysis,” said Professor Tetsuo Shoji of Osaka City University Graduate School of Medicine, Japan. “Death risk did not decrease either.”
Vitamin D, which is vital for bone, heart and brain health, must be converted by the liver and kidneys to its active form, 1,25-dihydroxyvitamin D. As a result, most patients with kidney disease requiring dialysis lack active vitamin D. These lower levels of vitamin D were thought to be partially responsible for the 10 to 30 times higher risk for death from cardiovascular disease in patients with chronic kidney disease.
Treatment with active vitamin D sterols has been available for more than 30 years, primarily to manage bone and mineral disorders in patients with kidney disease treated with dialysis. Active vitamin D treatment has dramatically improved bone health in such patients.
In addition, a number of observational studies revealed that the use of active vitamin D is associated with lower risks of all-cause mortality, cardiovascular mortality and incident cardiovascular disease in patients on dialysis. Basic research also showed potentially beneficial effects of active vitamin D on the heart, blood vessels, brain, immune system, endocrine system, and other organs.
“Many nephrologists consider that active vitamin D as a ‘longevity hormone’ or ‘panacea’ for patients with kidney failure, but there has been lack of evidence by randomized clinical trials,” said Shoji. “To obtain such evidence, we performed a randomized clinical trial named J-DAVID, but the result was really disappointing.”
Although the results confirmed that treatment with active vitamin D was beneficial for bone and mineral disorders, the treatment did not reduce the risk or cardiovascular disease or death, the researchers said.
The article can be found at: The J-DAVID Investigators (2018) Effect of Oral Alfacalcidol on Clinical Outcomes in Patients Without Secondary Hyperparathyroidism Receiving Maintenance Hemodialysis: The J-DAVID Randomized Clinical Trial.
Source: Osaka City University; Photo: Shutterstock.
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