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Ability of vitamin D receptor activator to prevent pulmonary congestion in advanced chronic kidney disease

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Abstract

Background

Vitamin D deficiency is common among patients with chronic kidney disease (CKD). However, the benefits of vitamin D supplementation versus vitamin D receptor activator (VDRA) administration have yet to be established. Recently, an association between activated vitamin D and cardiovascular factors was reported. To evaluate the benefits of VDRA in advanced CKD, we analyzed the association between VDRA administration and the prevalence of pulmonary congestion.

Methods

This retrospective, cross-sectional analysis included patients initiated on dialysis between October 2011 and September 2013 at 17 Japanese institutions. Data from 952 participants were analyzed using a multivariate logistic regression model and a linear regression model. We also analyzed subgroup data for groups classified by selection of peritoneal dialysis or hemodialysis.

Results

Of the 952 participants, 303 patients received VDRA. VDRA administration was associated with a low prevalence of pulmonary congestion in the multivariate logistic regression model (odds ratio [OR], 0.64; 95 % confidence interval [CI], 0.44–0.94; P = 0.02). There was no significant association between VDRA administration and systolic blood pressure, diastolic blood pressure, or pulse pressure. Subgroup analysis revealed a tendency that VDRA administration was associated with low prevalence of pulmonary congestion in both groups.

Conclusions

In this study, VDRA administration was associated with a low prevalence of pulmonary congestion in patients initiated on dialysis. Appropriate VDRA administration may prevent pulmonary congestion.

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Acknowledgments

We acknowledge the support of the following investigators, members of the Aichi cohort study of prognosis in patients newly initiated into dialysis (AICOPP), who participated in this study: Hirofumi Tamai (Anjo Kosei Hospital), Tomohiko Naruse (Kasugai Municipal Hospital), Kei Kurata (Tosei General Hospital), Hideto Oishi (Komaki City Hospital), Isao Aoyama (Social Insurance Chukyo Hospital), Hiroshi Ogawa (Shinseikai Daiichi Hospital), Hiroko Kushimoto(Chita City Hospital), Hideaki Shimizu (Chubu-Rosai Hospital), Junichiro Yamamoto (Tsushima City Hospital), Hisashi Kurata (Toyota Kosei Hospital), Taishi Yamakawa (Toyohashi Municipal Hospital), Takaaki Yaomura (Nagoya Medical Center), Hirotake Kasuga (Nagoya Kyouritsu Hospital), Shizunori Ichida (Japanese Red Cross Nagoya Daiichi Hospital), Shoichi Maruyama (Nagoya University Graduate School of Medicine), Noritoshi Kato (Nagoya University Graduate School of Medicine), Seiichi Matsuo (Nagoya University Graduate School of Medicine), Shigehisa Koide (Fujita Health University Hospital), and Yukio Yuzawa (Fujita Health University Hospital).

Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Kidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, 2–9, Myoken-cho, Showa-ku, Nagoya, 466–8650, Japan

    Shinichi Sueta, Kunio Morozumi, Asami Takeda, Keiji Horike, Yasuhiro Otsuka, Hibiki Shinjo, Minako Murata, Yuki Kato, Kazunori Goto & Daijo Inaguma

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  1. Shinichi Sueta
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  2. Kunio Morozumi
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  3. Asami Takeda
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  4. Keiji Horike
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  5. Yasuhiro Otsuka
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  6. Hibiki Shinjo
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  7. Minako Murata
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  8. Yuki Kato
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  9. Kazunori Goto
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  10. Daijo Inaguma
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and the Aichi cohort study of prognosis in patients newly initiated into dialysis (AICOPP) study group

Corresponding author

Correspondence to Shinichi Sueta.

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Sueta, S., Morozumi, K., Takeda, A. et al. Ability of vitamin D receptor activator to prevent pulmonary congestion in advanced chronic kidney disease. Clin Exp Nephrol 19, 371–378 (2015). https://doi.org/10.1007/s10157-014-0994-x

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  • DOI: https://doi.org/10.1007/s10157-014-0994-x

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