Vitamin D status and mortality risk in CKD: a meta-analysis of prospective studies
Pilz S, Iodice S, Zittermann A, Grant WB, Gandini S
American journal of kidney diseases : the official journal of the National Kidney Foundation · 208 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2011-06-19 · Am J Kidney Dis · vol. 58 · número 3 · págs. 374–382
- Editorial
- Elsevier BV
- Citado
- 299 citas · más que el 95% de estudios similares · 4.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 51 trabajos
- Acceso
- De pago
- Áreas de investigación
- Vitamin D Research Studies · Parathyroid Disorders and Treatments · Dialysis and Renal Disease Management
- Palabras clave
- vitamin D status, 25-hydroxyvitamin D, chronic kidney disease, all-cause mortality, vitamin D deficiency, survival, dialysis, estimated glomerular filtration rate
- MeSH
- humans, kidney failure, chronic, vitamin d deficiency, vitamin d, glomerular filtration rate, renal dialysis, risk factors, prospective studies
5 autores
- Stefan Pilz🇦🇹🇳🇱Medical University of Graz; Amsterdam Public Health; Amsterdam UMC Location Vrije Universiteit Amsterdam
- Simona Iodice🇮🇹European Institute of Oncology
- Armin Zittermann🇩🇪Heart and Diabetes Center North Rhine-Westphalia; Ruhr University Bochum
- William Burgess Grant🇺🇸Sunlight Nutrition and Health Research Center
- Sara Gandini🇮🇹 · autor de correspondenciaEuropean Institute of Oncology
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Vitamin D deficiency, assessed as low 25-hydroxyvitamin D (25[OH]D) level, is highly prevalent in patients with chronic kidney disease (CKD) and is associated with various adverse health outcomes. Whether low 25(OH)D levels in patients with CKD are an independent risk factor for mortality remains to be studied in detail, and this was the objective of our work.
Study design
A systematic review and meta-analysis of prospective observational studies.
Setting & population
Patients with CKD. CKD was diagnosed mainly as decreased estimated glomerular filtration rate.
Selection criteria for studies
We performed a systematic literature search in MEDLINE, ISI, and EMBASE to identify prospective studies reporting on 25(OH)D levels and mortality.
Predictor
25(OH)D serum concentrations.
Outcome
All-cause mortality.
Results
10 studies with an overall sample of 6,853 patients with CKD were included. Relative risk of mortality per 10-ng/mL (25-nmol/L) increase in 25(OH)D level was 0.86 (95% CI, 0.82-0.91), with no indication of publication bias or significant heterogeneity (I(2) =15%; P = 0.3). Summary estimates for CKD cohorts with and without dialysis treatment showed homogeneous results (P = 0.9).
Limitations
Results may be limited by heterogeneity, unconsidered confounders, and the observational design of the studies. Furthermore, publication bias by unpublished null findings on the association of 25(OH)D level and mortality cannot be ruled out and ascertainment of CKD was based largely on estimated glomerular filtration rate.
Conclusions
Higher 25(OH)D levels are associated with significantly improved survival in patients with CKD. Whether treatment of low 25(OH)D level using natural vitamin D supplementation improves survival in patients with CKD remains to be elucidated in randomized controlled trials.
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