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

• Published in: Clinical and experimental nephrology Vol. 19; no. 3; pp. 371 - 378
• Main Authors: Sueta, Shinichi, Morozumi, Kunio, Takeda, Asami, Horike, Keiji, Otsuka, Yasuhiro, Shinjo, Hibiki, Murata, Minako, Kato, Yuki, Goto, Kazunori, Inaguma, Daijo
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.06.2015; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Original Article; Prevalence; Pulmonary Edema - epidemiology; Pulmonary Edema - etiology; Receptors, Calcitriol - agonists; Regression Analysis; Renal Dialysis; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - therapy; Retrospective Studies; Urology; Vitamin D Deficiency - complications; Vitamin D Deficiency - drug therapy; Vitamin D receptor activator; Chronic kidney disease; Congestive heart failure
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-014-0994-x

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.