Vitamin D deficiency and treatment versus risk of infection in end-stage renal disease patients under dialysis: a systematic review and meta-analysis

Su, Guobin; Liu, Zhuangzhu; Qin, Xindong; Xu, Hong; Liu, Xusheng; Wen, Zehuai; Lindholm, Bengt; Carrero, Juan-Jesús; Johnson, David W.; Brusselaers, Nele; Lundborg, Cecilia Stålsby

doi:10.1093/ndt/gfy216

Cited by 15 publications

(9 citation statements)

References 103 publications

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“…Furthermore, there is some evidence to suggest an anti-infective effect of vitamin D in specific patient groups, such as patients with chronic kidney disease (CKD), human immunodeficiency virus (HIV) or hepatitis C virus (HCV) infection. Among patients with CKD receiving dialysis, a case-control study indicated that the risk of herpes zoster reactivation was significantly lower in those who received vitamin D supplementation15; another meta-analysis also showed that patients with CKD with higher or normal serum vitamin D levels had a lower risk of infection 16. Among HIV-infected patients, lower serum vitamin D levels were also associated with a higher risk of clinical progression to AIDS and all-cause mortality in a cohort study,17 while vitamin D supplementation did not affect mortality, CD4 cell count or viral load 18.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D deficiency or supplementation and the risk of human herpesvirus infections or reactivation: a systematic review protocol

et al. 2019

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IntroductionHuman herpesviruses induce lifelong latent infections and may reactivate as the immune system deteriorates. Recent studies have suggested that vitamin D, an essential element of bone health, may have some effect of protecting against infections, but investigations of its potential to prevent herpesvirus infection or reactivation are limited. We will review the current literature examining vitamin D and the risk of herpesvirus infections or reactivation.Methods and analysisOur systematic review will address two research questions: (1) Do deficient/insufficient serum vitamin D levels increase the risk of herpesvirus infections and (2) Does vitamin D supplementation protect against herpesvirus infections? We will include only intervention studies with control groups, cohort studies and case-control studies. We will use subject headings and keywords to search for synonyms of ‘vitamin D’ and ‘herpesviruses’ (including herpes simplex virus type 1 and 2, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus and human herpesviruses type 6, 7 and 8) in Medline, Embase, Global Health, Web of Science, Scopus and Cochrane Central Register of Controlled Trials, and the grey literature databases Open Grey, EThOS and BASE from inception to 31 August 2019. References to the included articles and relevant systematic reviews will also be examined. Two reviewers will independently screen the study titles and abstracts, and examine the full texts to decide the final eligibility. They will independently extract data from the studies and assess bias using the Cochrane Collaboration approach. A third researcher will solve any discrepancies. The results will be narratively synthesised; if an adequate number of studies is included and the homogeneity between studies is acceptable, a meta-analysis will be performed. We will assess the quality of evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework, and display the results in a summary of findings table.Ethics and disseminationEthical review is not required for a systematic review. We will publish the results in a peer-review journal. Any amendments to the protocol will be recorded in the supplementary section.PROSPERO registration numberCRD42019130153.

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Section: Introductionmentioning

confidence: 99%

Vitamin D deficiency or supplementation and the risk of human herpesvirus infections or reactivation: a systematic review protocol

et al. 2019

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“…At a cellular level, some studies have shown that vitamin D regulates the production of the antimicrobial peptide cathelicidin [ 10–13 ], and 1 study indicated that vitamin D supplementation was associated with a decrease in HSV-1 viral load and mRNA expression in HSV-1-infected cells [ 14 ]. In addition, among epidemiological studies, a meta-analysis showed that the risk of infection was lower in chronic kidney disease patients with normal or higher serum vitamin D levels [ 15 ], and another meta-analysis using original patient data from 25 randomized controlled trials showed that people receiving vitamin D supplementation had a lower risk of respiratory tract infection [ 16 ].…”

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confidence: 99%

Vitamin D Deficiency or Supplementation and the Risk of Human Herpesvirus Infections or Reactivation: A Systematic Review and Meta-analysis

Lin

Bhate

Forbes

et al. 2020

Open Forum Infectious Diseases

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Background Vitamin D may protect against respiratory virus infections, but any association with herpesviruses is unclear. Methods We undertook a systematic review of vitamin D deficiency or supplementation and the risk of 8 human herpesviruses. Six databases and 4 gray literature databases were searched for relevant cohort studies, case–control studies, and clinical trials. Results Ten studies were included, all conducted among immunosuppressed patients. There was no evidence that vitamin D deficiency is associated with cytomegalovirus (CMV) disease (pooled risk ratio, 1.06; 95% CI, 0.66–1.7), herpes zoster after transplantation (1 study), or HHV-8 among HIV patients (1 study). Vitamin D supplementation may decrease herpes zoster among hemodialysis patients (1 study) or CMV disease after renal transplantation (1 study), but supplementation was not associated with reduced EBV viral load among multiple sclerosis patients (1 study). Conclusions Any association between vitamin D and herpesviruses remains inconclusive. Further studies in the general population are needed.

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“…This result indicates that the fear of potential rejection or death after transplantation could invalidate the perception of having control over one’s life and goals, thus decreasing resilience. A recent review showed how the post-transplant phase is gripped by the fear of rejection, of possible infections, or return to dialysis despite the transplant [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Expressive Writing in Kidney Transplanted Patients: A Randomized Controlled Trial Study

et al. 2022

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The present study aimed to assess the effectiveness of an expressive writing (EW) intervention on psychological and physiological variables after kidney transplant. The final sample of 26 were randomly assigned to an expressive writing group (EWG) and control group (CG). Outcomes were focused on depression, anxiety, alexithymia, empathy, resilience, locus of control, creatinine, CDK-EPI, and azotemia. Depressive symptoms and alexithymia levels decreased in the EWG, with better adherence. Resilience declined over time in both groups. The EWG showed a significantly higher CDK-EPI, indicating better renal functioning. EW seems an effective intervention to improve the psychological health of transplanted patients, with a possible effect on renal functioning. These findings open the possibility of planning brief psychological interventions aimed at processing emotional involvement, in order to increase adherence, the acceptance of the organ, and savings in healthcare costs.

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Vitamin D deficiency and treatment versus risk of infection in end-stage renal disease patients under dialysis: a systematic review and meta-analysis

Abstract: High or normal serum levels of 25(OH)D and the use of vitamin D, particularly VDRA, were each associated with a lower risk of composite infection in long-term dialysis patients.

Cited by 15 publications

References 103 publications

Vitamin D deficiency or supplementation and the risk of human herpesvirus infections or reactivation: a systematic review protocol

Vitamin D deficiency or supplementation and the risk of human herpesvirus infections or reactivation: a systematic review protocol

Vitamin D Deficiency or Supplementation and the Risk of Human Herpesvirus Infections or Reactivation: A Systematic Review and Meta-analysis

Effectiveness of Expressive Writing in Kidney Transplanted Patients: A Randomized Controlled Trial Study

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