Importance of vitamin D repletion in uraemia

Fournier, A

doi:10.1093/ndt/14.4.819

Cited by 26 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…31% of the participants had a 25(OH)D 3 level <20 nmol/l which is considered vitamin D deficiency and another 31% had a vitamin D insufficient 25(OH)D 3 level between 20 and 40 nmol/l [39]. Patients who had a serum 25(OH)D 3 level <40 nmol/l were older, more likely diabetic and had lower serum albumin, higher iPTH and lower serum ferritin.…”

Section: Resultsmentioning

confidence: 99%

Serum 25(OH)-Cholecalciferol Concentration Is Associated with Hemoglobin Level and Erythropoietin Resistance in Patients on Maintenance Hemodialysis

Kiss¹,

Csaba

Almasi

et al. 2010

Nephron Clin Pract

View full text Add to dashboard Cite

Background: Resistance to erythropoiesis-stimulating agents (ESAs) has been observed in patients with chronic kidney disease (CKD) and it is associated with clinical outcomes. The presence of ESA resistance cannot always be explained by the known risk factors of the condition, suggesting that additional factors may be involved. We wanted to test the hypothesis that vitamin D insufficiency is associated with lower hemoglobin (Hb) and ESA resistance in patients on maintenance hemodialysis (HD). Methods: Data from patients receiving maintenance HD in a single dialysis center were extracted from the medical records in a retrospective chart review. Basic patient characteristics and laboratory data including Hb, serum albumin, intact parathyroid hormone and serum 25(OH)-cholecalciferol (25(OH)D₃) levels were collected. ESA dose and Kt/V were extracted from the dialysis charts. Correlation analysis and multivariate linear regression analysis were used to reveal potential independent associations between clinical and laboratory parameters and ESA resistance. Results: Data from 142 patients were analyzed. Serum 25(OH)D₃ concentration was significantly correlated with Hb (ρ = 0.186, p < 0.05) and also with ESA dose/Hb index (ρ = 0.230, p < 0.01). In multivariable regression analyses, serum 25(OH)D₃ concentration remained significantly associated with both Hb and ESA dose/Hb index after controlling for potentially important confounders. Conclusion: Serum 25(OH)D₃ concentration is independently associated with erythropoietin responsiveness in CKD patients on maintenance HD. If this association will be confirmed, treatment trials looking at the effect of vitamin D supplementation on anemia treatment in CKD patients may be warranted.

show abstract

Section: Resultsmentioning

confidence: 99%

Serum 25(OH)-Cholecalciferol Concentration Is Associated with Hemoglobin Level and Erythropoietin Resistance in Patients on Maintenance Hemodialysis

Kiss¹,

Csaba

Almasi

et al. 2010

Nephron Clin Pract

View full text Add to dashboard Cite

show abstract

“…Insufficient or deficient levels of circulating 25(OH) vitamin D and/or 1,25(OH) 2 vitamin D in CKD patients are associated with an increased prevalence of vascular calcification (63) and arterial stiffness (64), as well as with higher mortality (63,65 to 67). For many years, some authors had advised that calcifediol should be administered early in the course of CKD to hyperparathyroid patients with CKD, even when they are vitamin D replete (68). In recent years, it has become apparent that most, if not all, patients with advanced stages of CKD have vitamin D insufficiency or deficiency (69), and the same is true even in the general population (70).…”

Section: Case In Favor Of Vitamin D or Active Vitamin D Derivatives Amentioning

confidence: 99%

Treatment of Secondary Hyperparathyroidism in CKD Patients with Cinacalcet and/or Vitamin D Derivatives

Drüeke¹,

Ritz²

2009

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

The discovery of the calcium-sensing receptor (CaR) 15 yr ago was rapidly followed by the development of drugs modulating its activity, the so-called calcimimetics (increasing the CaR signal) and calcilytics (decreasing the CaR signal). The indication for calcimimetics is treatment of primary and secondary hyperparathyroidism, whereas calcilytics have potential for treatment of osteoporosis. A large number of clinical studies has shown that cinacalcet, the only presently available calcimimetic, effectively reduces serum parathyroid hormone in dialysis patients with secondary hyperparathyroidism. In contrast to the effect of active vitamin D derivatives, it simultaneously decreases serum calcium and phosphorus. Experimental studies showed a concomitant decrease in parathyroid hyperplasia. In the treatment of secondary hyperparathyroidism of dialysis patients, important questions remain unresolved, for example, whether there are reasons to prefer calcimimetics to active vitamin D derivatives and whether combined administration offers advantages compared with calcimimetics or active vitamin D given in isolation. For lowering parathyroid hormone, available evidence from recent studies suggests that combination therapy should be preferred to single drug treatment because of less side-effects and greater efficacy in controlling parathyroid overfunction. Future randomized controlled trial must answer whether calcimimetics impact on cardiovascular events or survival and whether in this respect there are differences between vitamin D sterols and calcimimetics.

show abstract

“…This evaluation was put aside for years because of studies performed with the polar metabolite calcitriol and its inhibitory effect on parathormone (PTH) gene transcription and PTH‐mediated cell proliferation. Data published by Fournier et al,12, 13 Halloran et al,14 and recently by Oprisiu et al15 have demonstrated that adequate 25‐hydroxy vitamin D (25 [OH]‐D) levels prevent and/or improve renal osteodystrophy and hyperparathyroidism. Intermediate metabolites different from calcitriol are important for bone mineralization.…”

mentioning

confidence: 99%

25‐Hydroxy Vitamin D Levels in Hemodialysis‐Requiring End‐Stage Renal Disease Patients

Díez

Fassi

Crucelequi

et al. 2008

Dialysis & Transplantation

View full text Add to dashboard Cite

BACKGROUND: Low vitamin D serum levels represent an additional risk factor for end-stage renal disease (ESRD)-associated bone disorders. The aim of this study was to evaluate the prevalence of vitamin D defi ciency in both the summer and winter seasons, as well as to defi ne the associated risk factors, and to establish the link between secondary hyperparathyroidism and circulating 25-hydroxy vitamin D (25 [OH]-D) serum levels.METHODS: Seventy-eight hemodialysis (HD)-requiring ESRD outpatients living in Buenos Aires, Argentina, age 57.2 Ϯ 2.07 years (21-86 years) were evaluated at the end of summer (SUM) and the end of winter (WIN). Then 25 (OH)-D, serum calcium (Ca), intact parathormone, ionized Ca (Ca ϩϩ ), phosphate, alkaline phosphatase, creatinine, C-reactive protein, and serum albumin were evaluated. The participants were evaluated according to the 25 (OH)-D levels following KDOQI guidelines. The participants were assigned to 2 groups according to their Karnofsky scores for functional capacity (FC): FC 1-2 (normal physical capacity full-time to only part-time) and FC 3-4 (limited capacity only for self care to needs permanent assistance). CONCLUSIONS: Fifty percent of the HD-requiring ESRD patients showed 25 (OH)-D insuffi ciency/defi ciency. This fi nding was more frequent in winter. Women and older patients were at higher risk. Those individuals displaying optimal 25 (OH)-D levels showed better health indicators for HD-requiring ESRD patients. FC assessed through the Karnofsky score was a useful clinical parameter able to identify patients at risk of 25 (OH)-D defi ciency. In our population, renal disease-associated secondary hyperparathyroidism did not correlate with vitamin D defi ciency.

show abstract

Importance of vitamin D repletion in uraemia

Cited by 26 publications

References 0 publications

Serum 25(OH)-Cholecalciferol Concentration Is Associated with Hemoglobin Level and Erythropoietin Resistance in Patients on Maintenance Hemodialysis

Serum 25(OH)-Cholecalciferol Concentration Is Associated with Hemoglobin Level and Erythropoietin Resistance in Patients on Maintenance Hemodialysis

Treatment of Secondary Hyperparathyroidism in CKD Patients with Cinacalcet and/or Vitamin D Derivatives

25‐Hydroxy Vitamin D Levels in Hemodialysis‐Requiring End‐Stage Renal Disease Patients

Contact Info

Product

Resources

About