Administration of alfacalcidol for patients with predialysis chronic kidney disease may reduce cardiovascular disease events

Sachiyo Sugiura, Daijo Inaguma, Akimitsu Kitagawa, Minako Murata, Yutaka Kamimura, Sho Sendo, Kyoko Hamaguchi, Hiroshi Nagaya, Miho Tatematsu, Kei Kurata, Yukio Yuzawa, Seiichi Matsuo

Research output: Contribution to journalArticle

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Abstract

Background: Besides its effect on calcium metabolism, vitamin D may play a part in preventing the onset and progression of cardiovascular disease (CVD) events. Only a few reports on the studies relating to whether vitamin D may reduce CVD events in patients with predialysis chronic kidney disease (CKD) are available, and many ambiguities remain. Methods: We conducted a retrospective cohort study of 665 patients with predialysis CKD. With log-rank test using the Kaplan-Meyer survival curve, comparison of incidences of CVD events, CVD-related mortality, and all-cause mortality were made between patients in the alfacalcidol treatment group (107 patients) in the predialysis stage to whom alfacalcidol 0.25-0.5 μg/day was orally administered for at least 24 weeks, and patients in the nontreatment group (558 patients) who received no administration of alfacalcidol or other type of activated vitamin D and its analogues. Patients to whom alfacalcidol administration was discontinued within 24 weeks as well as initiation of dialysis of <24 weeks were excluded for this study. Factors relating to CVD events were examined using Cox's proportional hazards analysis. Results: The mean follow-up period was 55.1 ± 38.9 months in the alfacalcidol treatment group and 41.9 ± 38.4 months in the nontreatment group. CVD events occurred in 172 patients during the follow-up period, and 74 of those occurred during the predialysis period. In the alfacalcidol treatment group, the incidence of cumulative CVD events was significantly lower. In relation to all-cause deaths and CVD-related deaths, the cumulative mortality rate was significantly lower in the alfacalcidol treatment group during the follow-up period. Throughout the follow-up period, the association between CVD events and alfacalcidol use was detected when adjusted for age, sex, diabetes, hypertension, use of renin-angiotensin system inhibitors, estimated glomerular filtration rate, and albumin and parathyroid hormone. Conclusion: These data showed that oral administration of alfacalcidol for predialysis CKD patients was associated with reduced risk for CVD.

Original languageEnglish
Pages (from-to)43-50
Number of pages8
JournalClinical and Experimental Nephrology
Volume14
Issue number1
DOIs
Publication statusPublished - 01-02-2010

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Chronic Renal Insufficiency
Cardiovascular Diseases
Vitamin D
Mortality
alfacalcidol
Incidence
Therapeutics
Renin-Angiotensin System
Parathyroid Hormone
Glomerular Filtration Rate
Oral Administration
Dialysis
Cause of Death
Albumins
Cohort Studies
Retrospective Studies
Hypertension
Calcium
Survival

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

Cite this

Sugiura, Sachiyo ; Inaguma, Daijo ; Kitagawa, Akimitsu ; Murata, Minako ; Kamimura, Yutaka ; Sendo, Sho ; Hamaguchi, Kyoko ; Nagaya, Hiroshi ; Tatematsu, Miho ; Kurata, Kei ; Yuzawa, Yukio ; Matsuo, Seiichi. / Administration of alfacalcidol for patients with predialysis chronic kidney disease may reduce cardiovascular disease events. In: Clinical and Experimental Nephrology. 2010 ; Vol. 14, No. 1. pp. 43-50.
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abstract = "Background: Besides its effect on calcium metabolism, vitamin D may play a part in preventing the onset and progression of cardiovascular disease (CVD) events. Only a few reports on the studies relating to whether vitamin D may reduce CVD events in patients with predialysis chronic kidney disease (CKD) are available, and many ambiguities remain. Methods: We conducted a retrospective cohort study of 665 patients with predialysis CKD. With log-rank test using the Kaplan-Meyer survival curve, comparison of incidences of CVD events, CVD-related mortality, and all-cause mortality were made between patients in the alfacalcidol treatment group (107 patients) in the predialysis stage to whom alfacalcidol 0.25-0.5 μg/day was orally administered for at least 24 weeks, and patients in the nontreatment group (558 patients) who received no administration of alfacalcidol or other type of activated vitamin D and its analogues. Patients to whom alfacalcidol administration was discontinued within 24 weeks as well as initiation of dialysis of <24 weeks were excluded for this study. Factors relating to CVD events were examined using Cox's proportional hazards analysis. Results: The mean follow-up period was 55.1 ± 38.9 months in the alfacalcidol treatment group and 41.9 ± 38.4 months in the nontreatment group. CVD events occurred in 172 patients during the follow-up period, and 74 of those occurred during the predialysis period. In the alfacalcidol treatment group, the incidence of cumulative CVD events was significantly lower. In relation to all-cause deaths and CVD-related deaths, the cumulative mortality rate was significantly lower in the alfacalcidol treatment group during the follow-up period. Throughout the follow-up period, the association between CVD events and alfacalcidol use was detected when adjusted for age, sex, diabetes, hypertension, use of renin-angiotensin system inhibitors, estimated glomerular filtration rate, and albumin and parathyroid hormone. Conclusion: These data showed that oral administration of alfacalcidol for predialysis CKD patients was associated with reduced risk for CVD.",
author = "Sachiyo Sugiura and Daijo Inaguma and Akimitsu Kitagawa and Minako Murata and Yutaka Kamimura and Sho Sendo and Kyoko Hamaguchi and Hiroshi Nagaya and Miho Tatematsu and Kei Kurata and Yukio Yuzawa and Seiichi Matsuo",
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Sugiura, S, Inaguma, D, Kitagawa, A, Murata, M, Kamimura, Y, Sendo, S, Hamaguchi, K, Nagaya, H, Tatematsu, M, Kurata, K, Yuzawa, Y & Matsuo, S 2010, 'Administration of alfacalcidol for patients with predialysis chronic kidney disease may reduce cardiovascular disease events', Clinical and Experimental Nephrology, vol. 14, no. 1, pp. 43-50. https://doi.org/10.1007/s10157-009-0233-z

Administration of alfacalcidol for patients with predialysis chronic kidney disease may reduce cardiovascular disease events. / Sugiura, Sachiyo; Inaguma, Daijo; Kitagawa, Akimitsu; Murata, Minako; Kamimura, Yutaka; Sendo, Sho; Hamaguchi, Kyoko; Nagaya, Hiroshi; Tatematsu, Miho; Kurata, Kei; Yuzawa, Yukio; Matsuo, Seiichi.

In: Clinical and Experimental Nephrology, Vol. 14, No. 1, 01.02.2010, p. 43-50.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Administration of alfacalcidol for patients with predialysis chronic kidney disease may reduce cardiovascular disease events

AU - Sugiura, Sachiyo

AU - Inaguma, Daijo

AU - Kitagawa, Akimitsu

AU - Murata, Minako

AU - Kamimura, Yutaka

AU - Sendo, Sho

AU - Hamaguchi, Kyoko

AU - Nagaya, Hiroshi

AU - Tatematsu, Miho

AU - Kurata, Kei

AU - Yuzawa, Yukio

AU - Matsuo, Seiichi

PY - 2010/2/1

Y1 - 2010/2/1

N2 - Background: Besides its effect on calcium metabolism, vitamin D may play a part in preventing the onset and progression of cardiovascular disease (CVD) events. Only a few reports on the studies relating to whether vitamin D may reduce CVD events in patients with predialysis chronic kidney disease (CKD) are available, and many ambiguities remain. Methods: We conducted a retrospective cohort study of 665 patients with predialysis CKD. With log-rank test using the Kaplan-Meyer survival curve, comparison of incidences of CVD events, CVD-related mortality, and all-cause mortality were made between patients in the alfacalcidol treatment group (107 patients) in the predialysis stage to whom alfacalcidol 0.25-0.5 μg/day was orally administered for at least 24 weeks, and patients in the nontreatment group (558 patients) who received no administration of alfacalcidol or other type of activated vitamin D and its analogues. Patients to whom alfacalcidol administration was discontinued within 24 weeks as well as initiation of dialysis of <24 weeks were excluded for this study. Factors relating to CVD events were examined using Cox's proportional hazards analysis. Results: The mean follow-up period was 55.1 ± 38.9 months in the alfacalcidol treatment group and 41.9 ± 38.4 months in the nontreatment group. CVD events occurred in 172 patients during the follow-up period, and 74 of those occurred during the predialysis period. In the alfacalcidol treatment group, the incidence of cumulative CVD events was significantly lower. In relation to all-cause deaths and CVD-related deaths, the cumulative mortality rate was significantly lower in the alfacalcidol treatment group during the follow-up period. Throughout the follow-up period, the association between CVD events and alfacalcidol use was detected when adjusted for age, sex, diabetes, hypertension, use of renin-angiotensin system inhibitors, estimated glomerular filtration rate, and albumin and parathyroid hormone. Conclusion: These data showed that oral administration of alfacalcidol for predialysis CKD patients was associated with reduced risk for CVD.

AB - Background: Besides its effect on calcium metabolism, vitamin D may play a part in preventing the onset and progression of cardiovascular disease (CVD) events. Only a few reports on the studies relating to whether vitamin D may reduce CVD events in patients with predialysis chronic kidney disease (CKD) are available, and many ambiguities remain. Methods: We conducted a retrospective cohort study of 665 patients with predialysis CKD. With log-rank test using the Kaplan-Meyer survival curve, comparison of incidences of CVD events, CVD-related mortality, and all-cause mortality were made between patients in the alfacalcidol treatment group (107 patients) in the predialysis stage to whom alfacalcidol 0.25-0.5 μg/day was orally administered for at least 24 weeks, and patients in the nontreatment group (558 patients) who received no administration of alfacalcidol or other type of activated vitamin D and its analogues. Patients to whom alfacalcidol administration was discontinued within 24 weeks as well as initiation of dialysis of <24 weeks were excluded for this study. Factors relating to CVD events were examined using Cox's proportional hazards analysis. Results: The mean follow-up period was 55.1 ± 38.9 months in the alfacalcidol treatment group and 41.9 ± 38.4 months in the nontreatment group. CVD events occurred in 172 patients during the follow-up period, and 74 of those occurred during the predialysis period. In the alfacalcidol treatment group, the incidence of cumulative CVD events was significantly lower. In relation to all-cause deaths and CVD-related deaths, the cumulative mortality rate was significantly lower in the alfacalcidol treatment group during the follow-up period. Throughout the follow-up period, the association between CVD events and alfacalcidol use was detected when adjusted for age, sex, diabetes, hypertension, use of renin-angiotensin system inhibitors, estimated glomerular filtration rate, and albumin and parathyroid hormone. Conclusion: These data showed that oral administration of alfacalcidol for predialysis CKD patients was associated with reduced risk for CVD.

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