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Vitamin D deficiency is associated with sudden cardiac death, combined cardiovascular events, and mortality in haemodialysis patients

Dialysis patients experience an excess mortality, predominantly of sudden cardiac death (SCD). Accumulating evidence suggests a role of vitamin D for myocardial and overall health. This study investigated the impact of vitamin D status on cardiovascular outcomes and fatal infections in haemodialysis...

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Main Authors: Drechsler, Christiane (Author) , Pilz, Stefan (Author) , Obermayer-Pietsch, Barbara (Author) , Verduijn, Marion (Author) , Tomaschitz, Andreas (Author) , Krane, Vera (Author) , Espe, Katharina (Author) , Dekker, Friedo (Author) , Brandenburg, Vincent (Author) , März, Winfried (Author) , Ritz, Eberhard (Author) , Wanner, Christoph (Author)
Format: Article (Journal)
Language:English
Published: 5 August 2010
In: European heart journal
Year: 2010, Volume: 31, Issue: 18, Pages: 2253-2261
ISSN:1522-9645
DOI:10.1093/eurheartj/ehq246
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/eurheartj/ehq246
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Author Notes:Christiane Drechsler, Stefan Pilz, Barbara Obermayer-Pietsch, Marion Verduijn, Andreas Tomaschitz, Vera Krane, Katharina Espe, Friedo Dekker, Vincent Brandenburg, Winfried März, Eberhard Ritz, and Christoph Wanner
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Summary:Dialysis patients experience an excess mortality, predominantly of sudden cardiac death (SCD). Accumulating evidence suggests a role of vitamin D for myocardial and overall health. This study investigated the impact of vitamin D status on cardiovascular outcomes and fatal infections in haemodialysis patients.25-hydroxyvitamin D [25(OH)D] was measured in 1108 diabetic haemodialysis patients who participated in the German Diabetes and Dialysis Study and were followed up for a median of 4 years. By Cox regression analyses, we determined hazard ratios (HR) for pre-specified, adjudicated endpoints according to baseline 25(OH)D levels: SCD (n = 146), myocardial infarction (MI, n = 174), stroke (n = 89), cardiovascular events (CVE, n = 414), death due to heart failure (n = 37), fatal infection (n = 111), and all-cause mortality (n = 545). Patients had a mean age of 66 ± 8 years (54% male) and median 25(OH)D of 39 nmol/L (interquartile range: 28-55). Patients with severe vitamin D deficiency [25(OH)D of≤ 25 nmol/L] had a 3-fold higher risk of SCD compared with those with sufficient 25(OH)D levels >75 nmol/L [HR: 2.99, 95% confidence interval (CI): 1.39-6.40]. Furthermore, CVE and all-cause mortality were strongly increased (HR: 1.78, 95% CI: 1.18-2.69, and HR: 1.74, 95% CI: 1.22-2.47, respectively), all persisting in multivariate models. There were borderline non-significant associations with stroke and fatal infection while MI and deaths due to heart failure were not meaningfully affected.Severe vitamin D deficiency was strongly associated with SCD, CVE, and mortality, and there were borderline associations with stroke and fatal infection. Whether vitamin D supplementation decreases adverse outcomes requires further evaluation.
Item Description:Gesehen am 16.02.2023
Physical Description:Online Resource
ISSN:1522-9645
DOI:10.1093/eurheartj/ehq246

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