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Article: Serum 25-hydroxyvitamin D status and cardiovascular outcomes in chronic peritoneal dialysis patients: A 3-y prospective cohort study

TitleSerum 25-hydroxyvitamin D status and cardiovascular outcomes in chronic peritoneal dialysis patients: A 3-y prospective cohort study
Authors
Issue Date2008
PublisherAmerican Society for Nutrition. The Journal's web site is located at http://www.ajcn.org/
Citation
American Journal Of Clinical Nutrition, 2008, v. 87 n. 6, p. 1631-1638 How to Cite?
AbstractBackground: Patients with kidney disease are at high risk of developing 25-hydroxyvitamin D [25(OH)D] deficiency. Objective: We studied the association between serum 25(OH)D status and clinical outcomes of chronic peritoneal dialysis patients. Design: We measured serum 25(OH)D concentrations in 230 prevalent peritoneal dialysis patients and then followed these patients prospectively for 3 y or until death. Results: Serum 25(OH)D was deficient or insufficient (ie, <75nmol/L) in 87% of the patients. Adjusting for clinical and demographic factors, every 1-unit increase in log-transformed serum 25(OH)D was associated with a 44% reduction in the hazard of fatal or nonfatal cardiovascular events (95% CI: 0.35, 0.91; P = 0.018). However, the association was gradually lost when additional adjustment was made in a stepwise fashion for residual glomerular filtration rate (P = 0.078) and echocardiographic measures (P = 0.39). Kaplan-Meier estimates showed a significantly greater fatal or non-fatal cardiovascular event-free survival probability among patients with serum 25(OH)D > 45.7 nmol/L (median) than among patients with concentrations ≤ 45.7 nmol/L (P = 0.004). In addition, patients with 25(OH)D > 45.7 nmol/L had a significantly higher cardiovascular event-free survival probability than did patients with 25(OH)D ≤ 45.7 nmol/L in the stratified analysis for patients with left ventricular mass index less than the median (P = 0.013) or normal systolic function (P = 0.005). Conclusions: A lower serum 25(OH)D concentration was associated with an increased risk of cardiovascular events in chronic peritoneal dialysis patients. Furthermore, serum 25(OH)D status appeared to show a differential influence on the cardiovascular outcomes of peritoneal dialysis patients depending on the degree of left ventricular hypertrophy and systolic dysfunction. © 2008 American Society for Nutrition.
Persistent Identifierhttp://hdl.handle.net/10722/163179
ISSN
2015 Impact Factor: 6.703
2015 SCImago Journal Rankings: 3.771
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWang, AYMen_US
dc.contributor.authorLam, CWKen_US
dc.contributor.authorSanderson, JEen_US
dc.contributor.authorWang, Men_US
dc.contributor.authorChan, IHSen_US
dc.contributor.authorLui, SFen_US
dc.contributor.authorSea, MMMen_US
dc.contributor.authorWoo, Jen_US
dc.date.accessioned2012-09-05T05:28:28Z-
dc.date.available2012-09-05T05:28:28Z-
dc.date.issued2008en_US
dc.identifier.citationAmerican Journal Of Clinical Nutrition, 2008, v. 87 n. 6, p. 1631-1638en_US
dc.identifier.issn0002-9165en_US
dc.identifier.urihttp://hdl.handle.net/10722/163179-
dc.description.abstractBackground: Patients with kidney disease are at high risk of developing 25-hydroxyvitamin D [25(OH)D] deficiency. Objective: We studied the association between serum 25(OH)D status and clinical outcomes of chronic peritoneal dialysis patients. Design: We measured serum 25(OH)D concentrations in 230 prevalent peritoneal dialysis patients and then followed these patients prospectively for 3 y or until death. Results: Serum 25(OH)D was deficient or insufficient (ie, <75nmol/L) in 87% of the patients. Adjusting for clinical and demographic factors, every 1-unit increase in log-transformed serum 25(OH)D was associated with a 44% reduction in the hazard of fatal or nonfatal cardiovascular events (95% CI: 0.35, 0.91; P = 0.018). However, the association was gradually lost when additional adjustment was made in a stepwise fashion for residual glomerular filtration rate (P = 0.078) and echocardiographic measures (P = 0.39). Kaplan-Meier estimates showed a significantly greater fatal or non-fatal cardiovascular event-free survival probability among patients with serum 25(OH)D > 45.7 nmol/L (median) than among patients with concentrations ≤ 45.7 nmol/L (P = 0.004). In addition, patients with 25(OH)D > 45.7 nmol/L had a significantly higher cardiovascular event-free survival probability than did patients with 25(OH)D ≤ 45.7 nmol/L in the stratified analysis for patients with left ventricular mass index less than the median (P = 0.013) or normal systolic function (P = 0.005). Conclusions: A lower serum 25(OH)D concentration was associated with an increased risk of cardiovascular events in chronic peritoneal dialysis patients. Furthermore, serum 25(OH)D status appeared to show a differential influence on the cardiovascular outcomes of peritoneal dialysis patients depending on the degree of left ventricular hypertrophy and systolic dysfunction. © 2008 American Society for Nutrition.en_US
dc.languageengen_US
dc.publisherAmerican Society for Nutrition. The Journal's web site is located at http://www.ajcn.org/en_US
dc.relation.ispartofAmerican Journal of Clinical Nutritionen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshCardiovascular Physiological Phenomenaen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshDiabetic Nephropathies - Therapyen_US
dc.subject.meshDiastoleen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshKidney Failure, Chronic - Therapyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPatient Selectionen_US
dc.subject.meshPeritoneal Dialysis - Adverse Effectsen_US
dc.subject.meshProbabilityen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshSurvival Analysisen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshVentricular Function, Leften_US
dc.subject.meshVitamin D - Analogs & Derivatives - Blooden_US
dc.subject.meshVitamin D Deficiency - Etiology - Prevention & Controlen_US
dc.titleSerum 25-hydroxyvitamin D status and cardiovascular outcomes in chronic peritoneal dialysis patients: A 3-y prospective cohort studyen_US
dc.typeArticleen_US
dc.identifier.emailWang, M:meiwang@hkucc.hku.hken_US
dc.identifier.authorityWang, M=rp00281en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid18541550en_US
dc.identifier.scopuseid_2-s2.0-45749148626en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-45749148626&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume87en_US
dc.identifier.issue6en_US
dc.identifier.spage1631en_US
dc.identifier.epage1638en_US
dc.identifier.isiWOS:000256724600009-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWang, AYM=13606226000en_US
dc.identifier.scopusauthoridLam, CWK=8531362100en_US
dc.identifier.scopusauthoridSanderson, JE=7202371250en_US
dc.identifier.scopusauthoridWang, M=7406690398en_US
dc.identifier.scopusauthoridChan, IHS=8298775100en_US
dc.identifier.scopusauthoridLui, SF=7102379144en_US
dc.identifier.scopusauthoridSea, MMM=6602566931en_US
dc.identifier.scopusauthoridWoo, J=36040369400en_US

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