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Düşük Serum 1,25-Dihidroksi Vitamin D Seviyesi Prevelan Hemodiyaliz Hastalarında Tüm Nedenli Mortalite Öngörücüsüdür

Low Levels of 1.25-Dihydroxy Vitamin D is associated with All-cause Mortality in Prevalent Hemodialysis Patients

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2010
DOI: 
10.5262/tndt.2010.1001.01

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
It has been suggested that vitamin D contributes not only to bone mineral metabolism but also to important other physiological processes. Vitamin D levels have been associated with increased mortality in predialysis and incident HD patients, but no data is available on the association between vitamin D levels and survival in prevalant hemodialysis (HD) patients. Five hundred and forty five prevalent hemodialysis patients were recruited. Time averaged laboratory values throughout the two years and base line serum 25-OH vitamin D and 1.25-OH vitamin D levels were determined. All-cause mortality was prospectively evaluated after 2-year follow-up period. 25- OH vitamin D levels were significantly lower in females and in patients with diabetes. 1.25-OH2 vitamin D level was significantly lower in diabetics. After two years of follow-up period, in crude analysis low serum 25-OH and 1.25 OH2 vitamin D levels were associated with all cause mortality. In adjusted Cox-regression analysis, 1.25-OH2 vitamin D level, but not 25-OH, was found as an independent predictor for all-cause mortality. Low 1.25-OH2 vitamin D level was also found as an independent predictor for all-cause mortality in non-diabetic study group even after inclusion of time averaged vitamin Dtherapy dosage. Serum 1.25-OH vitamin D level is associated with all cause mortality in prevalant hemodialysis patients.
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Abstract (Original Language): 
Vitamin D, kemik mineral metabolizması dışında da bir çok önemli fizyolojik süreçte rol oynamaktadır. İnsidan hemodiyaliz ve prediyaliz dönem hastalarda vitamin D düzeyi ile mortalite ilişkisi gösterilmiştir. Ancak prevelan hemodiyaliz hastalarında serum vitamin D düzeyi ile mortalite ilişkisi hakkında çok az veri vardır. Bu çalışmaya 545 prevelan hemodiyaliz hastası alındı. Hastaların bazal serum 25-Hidroksi ve 1,25- Dihidroksi vitamin D düzeyleri ve 2 yıl boyunca zamansal ortalamalı laboratuvar verileri belirlendi. Tüm nedenli mortalite, prospektif olarak bu 2 yıl sonunda incelendi. 25-Hidroksi vitamin D kadınlarda ve diyabetiklerde anlamlı olarak daha düşük saptandı. 1,25-Dihidroksi vitamin D de aynı şekilde diyabetiklerde anlamlı daha düşük saptandı. İki yıl sonunda, 25-Hidroksi ve 1,25-Dihidroksi vitamin D düzeyleri, prevelan hemoidiyaliz hastalarında tüm nedenli mortalite öngörücüsü olarak saptandı. Cox regresyon analizinde 1,25-Dihidroksi vitamin D düzeyi bağımsız tüm nedenli mortalite öngörücüsü olarak saptandı. Diyabetik olmayan prevelan hemodiyaliz hastalarında aktif vitamin D tedavisi modele eklendiğinde bile 1,25-Dihidroksi vitamin D düzeyi bağımsız tüm nedenli mortalite öngörücüsü idi. Serum 1,25-Dihidroksi vitamin D düzeyi prevelan hemodiyaliz hastalarında tüm nedenli mortalite öngörücüsüdür.
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11-16
  • Turkish

REFERENCES

References: 

1. Forman JP, Bischoff-Ferrari HA, Willett WC, Stampfer MJ,
Curhan GC :Vitamin D intake and risk of incident hypertension:
Results from three large prospective cohort studies. Hypertension.
2005; 46(4):676-682
2. Rammos G, Tseke P, Ziakka S: Vitamin D, the renin-angiotensin
system, and insulin resistance. Int Urol Nephrol 2008; 40 (2):
419-426
3. Lemire JM: Immunomodulatory role of 1,25 dihydroxyvitamin
D. J Cell Biochem 1992; 49: 26-31
4. Cantorna MT, Hayes CE, DeLuca HF: 1,25-dihydroxyvitamin D
reversibly blocks the progression of relapsing encephalomyelitis.
Proc Natl Acad Sci U S A 1996; 93: 7861-7864
5. Cantorna MT, Hayes CE, DeLuca HF: 1,25-
dihydroxycholecalciferol inhibits the progression of arthritis in
murine models of human arthritis. J Nutr 1998; 128: 68-72
6. Mizobuchi M, Finch JL, Martin DR, Slatopolsky E: Differential
effects of vitamin D receptor activators on vascular calcification
in uremic rats. Kidney Int 2007;72(6):709-715
7. Pilz S, Dobnig H, Nijpels G, Heine RJ, Stehouwer CD, Snijder
MB, van Dam RM, Dekker JM: Vitamin D and mortality in older
men and women. Clin Endocrinol (Oxf). 2009;71(5): 666-672
8. Ginde AA, Scragg R, Schwartz RS, Camargo CA Jr: Prospective
study of serum 25-hydroxyvitamin D level, cardiovascular
disease mortality, and all-cause mortality in older U.S. Adults. J
Am Geriatr Soc 2009;57 (9):1 595-603
9. Kuroda T, Shiraki M, Tanaka S, Ohta H: Contributions of 25-
hydroxyvitamin D, co-morbidities and bone mass to mortality in
Japanese postmenopausal women. Bone 2009; 44(1):168-172
10. Wolf M, Shah A, Gutierrez O, Ankers E, Monroy M, Tamez
H, Steele D, Chang Y, Camargo CA Jr, Tonelli M, Thadhani R:
Vitamin D levels and early mortality among incident hemodialysis
patients. Kidney Int 2007; 72: 1004-1013
11. Jacob AI, Sallman A, Santiz Z, Hollis BW: Defective
photoproduction of cholecalciferol in normal and uremic humans.
J Nutr 1984; 114 (7): 1313-1319
12. LaClair RE, Hellman RN, Karp SL, Kraus M, Ofner S, Li Q,
Graves KL, Moe SM: Prevalence of calcidiol deficiency in CKD:
A cross-sectional study across latitudes in the United States. Am
J Kidney Dis 2005; 45: 1026–1033
13. Ishimura E, Nishizawa Y, Inaba M, Matsumoto N, Emoto M,
Kawagishi T, Shoji S, Okuno S, Kim M, Miki T, Morii H: Serum
levels of 1,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D,
and 25-hydroxyvitamin D in nondialyzed patients with chronic
renal failure. Kidney Int 1999;55:1019–1027
Bozkurt D et al: Low Levels of 1.25-Dihydroxy Vitamin D is associated
with All-cause Mortality in Prevalent Hemodialysis Patients
Cilt/Vol: 19, No: 1, 2010, Sayfa/Page: 11-16
Türk Nefroloji Diyaliz ve Transplantasyon Dergisi
Turkish Nephrology, Dialysis and Transplantation Journal
14. Hur SJ, Kim DM, Lim KH, Yoon SH, Chung HC, Lee JS, and
Park J: Vitamin D levels and their relationship with cardiac
biomarkers in chronic hemodialysis patients. J Korean Med Sci
2009; 24(Suppl 1): S109–S114
15. Michos ED, Melamed ML: Vitamin D and cardiovascvular
disease risk. Curr Opin Clin Nutr Metab Care 2008; 11: 7-12
16. Ravani P, Malberti F, Tripepi G, Pecchini P, Cutrupi S, Pizzini P,
Mallamaci F, Zoccali C: Vitamin D levels and patient outcome in
chronic kidney disease. Kidney Int 2009 ; 75: 88-95
17. Moe SM: Vitamin D, cardiovascular disease, and survival in
dialysis patients. J Bone Miner Res 2007;22 Suppl 2:V95-99
18. Glenville J: Expanding role for vitamin D in chronic kidney
disease. Semin in Dial, 2007; 20 (4): 316-324
19. Wang AY, Lam CW, Sanderson JE, Wang M, Chan IH, Lui
SF, Sea MM, Woo J: Serum 25-hydroxyvitamin D status and
cardiovascular outcomes in chronic peritoneal dialysis patients:
A 3-y prospective cohort study. Am J Clin Nutr 2008;87(6):
1631-1638
20. Zittermann A, Schleithoff SS, Koerfer R: Putting cardiovascular
disease and vitamin D insufficiency into perspective.Br J Nutr
2005 ;94(4):483-492
21. Hypponen E, Power C: Vitamin D status and glucose homeostasis
in the 1958 British birth cohort: The role of obesity. Diabetes
Care 2006; 29:2244–2246
22. Hintzpeter B, Mensink GB, Thierelder W Müller MJ, Scheidt-
Nave C:Vitamin D status and health correlates among German
Adults. Eur J Clin Nutr 2007; 69(2):1079-1089
23. Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R,
Felsenfeld A, Levine B, Mehrotra R, Norris K : Prevalence
of cardiovascular risk factors and the serum levels of 25-
hydroxyvitamin D in the United States: Data from the Third
National Health and Nutrition Examination Survey. Arch Intern
Med 2007; 167:1159–1165
24. Ravani P, Malberti F, Tripepi G, Pecchini P, Cutrupi S, Pizzini P,
Mallamaci F, Zoccali C: Vitamin D levels and patient outcome in
chronic kidney disease Kidney Int 2009;75(1):88-95
25. Calatayud M, Jódar E, Sánchez R, Guadalix S, Hawkins F.
Prevalence of deficient and insufficient vitamin D levels in a
young healthy population. Endocrinol Nutr 2009;56(4):164-169
26. Scragg R, Sowers M, Bell C: Serum 25-hydroxyvitamin D,
ethnicity, and blood pressure in the Third National Health and
Nutrition Examination Survey. Am J Hypertens 2007;20(7):713-
719
27. Snijder MB, Lips P, Seidell JC, Visser M, Deeg DJ, Dekker JM,
van Dam RM: Vitamin D status and parathyroid hormone levels
in relation to blood pressure: a population-based study in older
men and women. J Intern Med 2007;261(6):558-565
28. Ozkahya M, Ok E, Toz H, Asci G, Duman S, Basci A, Kose T,
Dorhout Mees EJ: Long-term survival rates in haemodialysis
patients treated with strict volume control. Nephrol Dial
Transplant. 2006 ;21(12):3506-3513
29. Aşci G, Ozkahya M, Duman S, Toz H, Erten S, Ok E. Volume
control associated with better cardiac function in long-term
peritoneal dialysis patients.Perit Dial Int 2006;26(1):85-88
30. Ozkahya M, Toz H, Qzerkan F, Duman S, Ok E, Basci A, Mees
EJ:Impact of volume control on left ventricular hypertrophy in
dialysis patients. J Nephrol 2002;15(6):655-660
31. Günal AI, Duman S, Ozkahya M, Töz H, Asçi G, Akçiçek F, Basçi
A: Strict volume control normalizes hypertension in peritoneal
dialysis patients. Am J Kidney Dis 2001;37(3):588-593
32. Ozkahya M, Töz H, Unsal A, Ozerkan F, Asci G, Gürgün C,
Akçiçek F, Mees EJ: Treatment of hypertension in dialysis
patients by ultrafiltration: Role of cardiac dilatation and time
factor. Am J Kidney Dis 1999;34(2):218-221
33. Ozkahya M, Ok E, Cirit M, Aydin S, Akçiçek F, Başçi A,
Dorhout Mees EJ: Regression of left ventricular hypertrophy
in haemodialysis patients by ultrafiltration and reduced salt
intake without antihypertensive drugs. Nephrol Dial Transplant
1998;13(6):1489-1493

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