10.6084/m9.figshare.5124577.v1
Duranton F.
Duranton
F.
Rodriguez-Ortiz M.E.
Rodriguez-Ortiz
M.E.
Duny Y.
Duny
Y.
Rodriguez M.
Rodriguez
M.
Daurès J.-P.
Daurès
J.-P.
Argilés A.
Argilés
A.
Supplementary Material for: Vitamin D Treatment and Mortality in Chronic Kidney Disease: A Systematic Review and Meta-Analysis
Karger Publishers
2013
Chronic kidney disease
Vitamin D
Survival
Mortality
Cardiovascular mortality
2013-03-05 00:00:00
Dataset
https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Vitamin_D_Treatment_and_Mortality_in_Chronic_Kidney_Disease_A_Systematic_Review_and_Meta-Analysis/5124577
<b><i>Background/Aims:</i></b> Hypovitaminosis D has been associated with an increased cardiovascular mortality in the general population and in patients with chronic kidney disease (CKD). Still, whether prescribing vitamin D reduces the risk of mortality in renal patients remains controversial. <b><i>Methods:</i></b> We searched PubMed, ClinicalTrials.gov and the Cochrane Library for long-term longitudinal studies comparing vitamin D compounds (25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and synthetic derivatives) to placebo or no treatment in renal patients, and which evaluated mortality, to perform a meta-analysis. Data concerning study quality, population and effect size were extracted independently by two investigators using predefined forms. <b><i>Results:</i></b> Fourteen observational studies (194,932 patients) met all eligibility criteria. Most studies were performed in hemodialysis patients and all used calcitriol or synthetic analogues. In a random effects meta-analysis, receiving any vitamin D therapy significantly reduced the risk of all-cause mortality (relative risk 0.73, 95% CI 0.65-0.82). The relative risk of death was 0.72 (95% CI 0.65-0.80) after 3 years of therapy and 0.67 (95% CI 0.45-0.98) after 5 years. In meta-regression, the risk reduction was shown to be greater in patients with higher parathyroid hormone serum levels (p = 0.01). The risk of cardiovascular mortality was also significantly reduced in patients receiving any vitamin D derivative (relative risk 0.63, 95% CI 0.44-0.92). <b><i>Conclusion:</i></b> Therapies with 1,25-dihydroxyvitamin D and analogues are associated with reduced mortality in CKD patients, and particularly in those suffering from secondary hyperparathyroidism. These results, based on observational evidence, are supportive of prescribing vitamin D therapies to CKD patients, while respecting good practice guidelines.