Relationship between selection of dosage forms of vitamin D receptor activators and short-term survival of patients on hemodialysis

Background The benefits of vitamin D receptor activators (VDRAs) for patients with chronic kidney disease are well recognized. However, the optimal criteria for patient selection, dosage forms, and duration providing the highest benefit and the least potential risk remain to be confirmed. Materials...

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Autores principales:	Eri Koshi-Ito, Daijo Inaguma, Shigehisa Koide, Kazuo Takahashi, Hiroki Hayashi, Naotake Tsuboi, Midori Hasegawa, Shoichi Maruyama, Yukio Yuzawa
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	vitamin d dialysis mortality vitamin d receptor activator chronic kidney disease Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/955a63da704c46c58c0ba6a46d26660c
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spelling	oai:doaj.org-article:955a63da704c46c58c0ba6a46d26660c2021-11-26T11:19:46ZRelationship between selection of dosage forms of vitamin D receptor activators and short-term survival of patients on hemodialysis0886-022X1525-604910.1080/0886022X.2021.1995423https://doaj.org/article/955a63da704c46c58c0ba6a46d26660c2021-01-01T00:00:00Zhttp://dx.doi.org/10.1080/0886022X.2021.1995423https://doaj.org/toc/0886-022Xhttps://doaj.org/toc/1525-6049Background The benefits of vitamin D receptor activators (VDRAs) for patients with chronic kidney disease are well recognized. However, the optimal criteria for patient selection, dosage forms, and duration providing the highest benefit and the least potential risk remain to be confirmed. Materials and methods The study population was derived from the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis, a multicenter prospective cohort study of 1520 incident dialysis patients. According to the VDRA usage status in March 2015 (interim report), the 967 patients surviving after March 2015 were classified into three groups: without VDRA (NV, n = 177), oral VDRA (OV, n = 447), and intravenous VDRA (IV, n = 343). Mortality rates were compared using the log-rank test, and factors contributing to all-cause mortality were examined using both univariate and multivariate Cox proportional hazard regression analyses. Results There were 104 deaths (NV, n = 27; OV, n = 53; IV, n = 24) during the follow-up period (1360 days, median), and significant differences in cumulative survival rates were observed between the three groups (p = 0.010). Moreover, lower all-cause mortality was associated with IV versus NV (hazard ratio, 0.46 [95% confidence interval 0.24–0.89]; p = 0.020). Conclusion This study demonstrated the impact of the VDRA dosage form on the short-term survival of incident hemodialysis patients during the introduction period. Our results suggest that relatively early initiation of intravenous VDRA in patients beginning hemodialysis may have some clinical potential.Eri Koshi-ItoDaijo InagumaShigehisa KoideKazuo TakahashiHiroki HayashiNaotake TsuboiMidori HasegawaShoichi MaruyamaYukio YuzawaTaylor & Francis Grouparticlevitamin ddialysismortalityvitamin d receptor activatorchronic kidney diseaseDiseases of the genitourinary system. UrologyRC870-923ENRenal Failure, Vol 43, Iss 1, Pp 1528-1538 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	vitamin d dialysis mortality vitamin d receptor activator chronic kidney disease Diseases of the genitourinary system. Urology RC870-923
spellingShingle	vitamin d dialysis mortality vitamin d receptor activator chronic kidney disease Diseases of the genitourinary system. Urology RC870-923 Eri Koshi-Ito Daijo Inaguma Shigehisa Koide Kazuo Takahashi Hiroki Hayashi Naotake Tsuboi Midori Hasegawa Shoichi Maruyama Yukio Yuzawa Relationship between selection of dosage forms of vitamin D receptor activators and short-term survival of patients on hemodialysis
description	Background The benefits of vitamin D receptor activators (VDRAs) for patients with chronic kidney disease are well recognized. However, the optimal criteria for patient selection, dosage forms, and duration providing the highest benefit and the least potential risk remain to be confirmed. Materials and methods The study population was derived from the Aichi Cohort Study of Prognosis in Patients Newly Initiated into Dialysis, a multicenter prospective cohort study of 1520 incident dialysis patients. According to the VDRA usage status in March 2015 (interim report), the 967 patients surviving after March 2015 were classified into three groups: without VDRA (NV, n = 177), oral VDRA (OV, n = 447), and intravenous VDRA (IV, n = 343). Mortality rates were compared using the log-rank test, and factors contributing to all-cause mortality were examined using both univariate and multivariate Cox proportional hazard regression analyses. Results There were 104 deaths (NV, n = 27; OV, n = 53; IV, n = 24) during the follow-up period (1360 days, median), and significant differences in cumulative survival rates were observed between the three groups (p = 0.010). Moreover, lower all-cause mortality was associated with IV versus NV (hazard ratio, 0.46 [95% confidence interval 0.24–0.89]; p = 0.020). Conclusion This study demonstrated the impact of the VDRA dosage form on the short-term survival of incident hemodialysis patients during the introduction period. Our results suggest that relatively early initiation of intravenous VDRA in patients beginning hemodialysis may have some clinical potential.
format	article
author	Eri Koshi-Ito Daijo Inaguma Shigehisa Koide Kazuo Takahashi Hiroki Hayashi Naotake Tsuboi Midori Hasegawa Shoichi Maruyama Yukio Yuzawa
author_facet	Eri Koshi-Ito Daijo Inaguma Shigehisa Koide Kazuo Takahashi Hiroki Hayashi Naotake Tsuboi Midori Hasegawa Shoichi Maruyama Yukio Yuzawa
author_sort	Eri Koshi-Ito
title	Relationship between selection of dosage forms of vitamin D receptor activators and short-term survival of patients on hemodialysis
title_short	Relationship between selection of dosage forms of vitamin D receptor activators and short-term survival of patients on hemodialysis
title_full	Relationship between selection of dosage forms of vitamin D receptor activators and short-term survival of patients on hemodialysis
title_fullStr	Relationship between selection of dosage forms of vitamin D receptor activators and short-term survival of patients on hemodialysis
title_full_unstemmed	Relationship between selection of dosage forms of vitamin D receptor activators and short-term survival of patients on hemodialysis
title_sort	relationship between selection of dosage forms of vitamin d receptor activators and short-term survival of patients on hemodialysis
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/955a63da704c46c58c0ba6a46d26660c
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Relationship between selection of dosage forms of vitamin D receptor activators and short-term survival of patients on hemodialysis

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