Life Extension Update Exclusive Half of dialysis patients fail to receive life-saving vitamin An article published online in advance of the April issue of the Journal of the American Society of Nephrology (www.jasn.org) found that administering injectable vitamin D to chronic kidney failure patients who are undergoing dialysis significantly improves survival. The annual mortality rate of dialysis patients is currently 20 percent in the United States, due mainly to cardiovascular disease. Because individuals with failing kidneys cannot effectively utilize vitamin D provided by the diet, injections have been recommended, but only for those with hyperparathyroidism meaning that about half of those receiving dialysis are lacking in the vitamin. The current research sought to determine the impact on survival of vitamin D injections in dialysis patients. Director of clinical research at Massachusetts General Hospital, Ravi Thadhani, MD, and researchers from Fresenius Medical Care North America analyzed information from 51,037 patients who received dialysis at Fresenius centers beginning in 1996 to 1999. Activated injectable vitamin D was received by 37,173 of the patients in this study, while the remaining 13,864 subjects did not receive the vitamin. After two years of dialysis, 76 percent of those who received vitamin D injections were still living, compared to 59 percent of patients who did not receive the vitamin. Elevation of calcium or phosphorus secondary to treatment with vitamin D did not adversely impact survival in those who received it. Cardiovascular mortality of those who received no vitamin D was nearly double that of those who received it. Dr Thadhani stated, "We've been administering vitamin D injections for decades, but the potential benefit on survival has never been studied. This finding was a surprise and should force us to think more broadly about who should be treated. While these results need to be verified, we at least need to be more aggressive in treating people that meet the current criteria. Thereafter we need to investigate what is the mechanism conferring this survival benefit. We are actively pursuing that with a focus on the effects on cardiovascular disease." |