Vitamin D and Clinical Outcomes in Dialysis.
Vitamin D and Clinical Outcomes in Dialysis.
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DOI：
10.1111/sdi.12446
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发表时间：
2015-11
影响因子：
1.6
通讯作者：
Melamed ML
中科院分区：
文献类型：
--
作者：
Parikh C;Gutgarts V;Eisenberg E;Melamed ML
Most dialysis patients are vitamin D deficient, including deficiencies in both activated vitamin D (1, 25-dihydroxyvitamin D) and the less active 25-hydroxyvitamin D. These and other abnormalities associated with chronic kidney disease (CKD), if they remain untreated, lead to secondary hyperparathyroidism and bone changes, such as osteitis fibrosa cystica. Activated vitamin D has been proven to decrease parathyroid hormone (PTH) levels in dialysis patients and is currently used for this indication. There are multiple other potential “pleotrophic” effects associated with vitamin D therapy. These include associations with lower all-cause and cardiovascular mortality, lower rates of infections and improved glycemic indexes. Meta-analyses of multiple observational studies have shown activated vitamin D therapy to be associated with improved survival. Observational data also suggest fewer infections and better glucose control. There have been no randomized clinical trials powered to evaluate mortality or other clinical outcomes. Small trials of nutritional vitamin D (ergocalciferol and cholecalciferol) showed increases in 25-hydroxyvitamin D levels without hypercalcemia or hyperphosphatemia, even when given in addition to activated vitamin D therapy. While activated vitamin D therapy is associated with improved outcomes, it also leads to higher fibroblast growth factor 23 (FGF-23) levels, which may be detrimental in dialysis patients. Further research is needed to evaluate whether activated or nutritional vitamin D therapy are beneficial in dialysis patients for outcomes other than secondary hyperparathyroidism.
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DOI：
10.1056/nejmoa0706130
发表时间：
2008-08-07
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gutiérrez OM;Mannstadt M;Isakova T;Rauh-Hain JA;Tamez H;Shah A;Smith K;Lee H;Thadhani R;Jüppner H;Wolf M
通讯作者：
Wolf M
影响因子：
19.6
作者：
通讯作者：
--
影响因子：
6.2
作者：
Cardus, Anna;Panizo, Sara;Valdivielso, Jose M.
通讯作者：
Valdivielso, Jose M.
DOI：
10.1086/596314
发表时间：
2009-02-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Gombart AF;Bhan I;Borregaard N;Tamez H;Camargo CA Jr;Koeffler HP;Thadhani R
通讯作者：
Thadhani R
影响因子：
19.6
作者：
Fliser, D;Pacini, G;Ritz, E
通讯作者：
Ritz, E