
Activated vitamin D administered to patients
with moderate to severe chronic kidney disease
(CKD) reduces mortality by a fourth, according
to the latest findings.
The findings are based
on a study of 1,418 patients with moderate
to severely impaired kidney function. They
also had high parathyroid hormone levels (hyperparathyroidism),
which can contribute to weakening of the bones
in CKD patients.
Researchers identified
a group that was being treated with calcitriol
to lower parathyroid hormone levels, and another
group that was not receiving calcitriol.
Patients with advanced
CKD take calcitriol, an oral form of activated
vitamin D, to treat elevated levels of parathyroid
hormone, explained Bryan Kestenbaum of the
University of Washington, one of the co-authors
of the study.
During a two-year follow-up
period, mortality rates were compared for
patients who were and were not taking calcitriol.
"We then adjusted for differences in
age, kidney function, parathyroid hormone
levels, other illnesses, and other medications,"
says Kestenbaum.
In the adjusted analysis,
the overall risk of death was about 26 percent
lower for patients taking calcitriol. Patients
on calcitriol were also less likely to develop
end-stage renal disease, requiring dialysis
to replace lost kidney function.
"Recently, there
has been an increased focus on the effects
of vitamin D beyond those on bone health,"
Kestenbaum comments. "Vitamin D deficiency
has been associated with risk factors for
cardiovascular disease, such as high blood
pressure, diabetes, and inflammation."