دورية أكاديمية
أعرض في EDS

Active Vitamin D Use and Fractures in Hemodialysis Patients: Results from the International DOPPS.

التفاصيل البيبلوغرافية
العنوان: Active Vitamin D Use and Fractures in Hemodialysis Patients: Results from the International DOPPS.
المؤلفون: Komaba H; Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan.; The Institute of Medical Sciences, Tokai University, Isehara, Japan., Zhao J; Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA., Karaboyas A; Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA., Yamamoto S; Division of Clinical Nephrology and Rheumatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan., Dasgupta I; Renal Medicine, University Hospitals Birmingham, Birmingham, UK.; Warwick Medical School, University of Warwick, Coventry, UK., Hassan M; Seha Kidney Care, Abu Dhabi, UAE., Zuo L; Department of Nephrology, Peking University People's Hospital, Beijing, China., Christensson A; Department of Nephrology, Skåne University Hospital, Lund University, Malmö, Sweden., Combe C; Service de Néphrologie Transplantation Dialyse Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France., Robinson BM; Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA.; Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA., Fukagawa M; Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan.
المصدر: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research [J Bone Miner Res] 2023 Nov; Vol. 38 (11), pp. 1577-1585. Date of Electronic Publication: 2023 Sep 30.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: England NLM ID: 8610640 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1523-4681 (Electronic) Linking ISSN: 08840431 NLM ISO Abbreviation: J Bone Miner Res Subsets: MEDLINE
أسماء مطبوعة: Publication: January 2024- : [Oxford] : Oxford University Press
Original Publication: New York : Mary Ann Liebert, Inc., c1986-
مواضيع طبية MeSH: Hyperparathyroidism, Secondary*/complications , Hyperparathyroidism, Secondary*/drug therapy , Hyperparathyroidism, Secondary*/epidemiology , Hip Fractures*/complications , Vitamin D Deficiency*/complications, Humans ; Vitamin D ; Renal Dialysis/adverse effects ; Parathyroid Hormone
مستخلص: Active vitamin D is commonly used to control secondary hyperparathyroidism in dialysis patients, but it is unknown whether active vitamin D directly improves bone strength, independently of its ability to suppress parathyroid hormone (PTH). We analyzed the association between the prescription of active vitamin D and incidence of any fracture and hip fracture in 41,677 in-center hemodialysis patients from 21 countries in phases 3 to 6 (2005 to 2018) of the Dialysis Outcomes and Practice Patterns Study (DOPPS). We used Cox regression, adjusted for PTH and other potential confounders, and used a per-protocol approach to censor patients at treatment switch during follow-up. We also used a facility preference approach to minimize confounding by indication. Overall, 55% of patients were prescribed active vitamin D at study enrollment. Event rates (per patient-year) were 0.024 for any fracture and 0.010 for hip fracture. The adjusted hazard ratio (95% confidence interval) comparing patients prescribed versus not prescribed active vitamin D was 1.02 (0.90 to 1.17) for any fracture and 1.00 (0.81 to 1.23) for hip fracture. In the facility preference approach, there was no difference in fracture rate between facilities with higher versus lower active vitamin D prescriptions. Thus, our results do not suggest a PTH-independent benefit of active vitamin D in fracture prevention and support the current KDIGO guideline suggesting the use of active vitamin D only in subjects with elevated or rising PTH. Further research is needed to determine the role of active vitamin D beyond PTH control. © 2023 American Society for Bone and Mineral Research (ASBMR).
(© 2023 American Society for Bone and Mineral Research (ASBMR).)
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معلومات مُعتمدة: This manuscript was financially supported by Kyowa Kirin. Global support for ongoing DOPPS Programs is provided without restriction on publications by a variety of funders (details in https://www.dopps.org/AboutUs/Support.aspx).
فهرسة مساهمة: Keywords: ACTIVE VITAMIN D; BONE METABOLISM; FRACTURE; HEMODIALYSIS; PARATHYROID HORMONE; SECONDARY HYPERPARATHYROIDISM
المشرفين على المادة: 1406-16-2 (Vitamin D)
0 (Parathyroid Hormone)
تواريخ الأحداث: Date Created: 20230918 Date Completed: 20231204 Latest Revision: 20240411
رمز التحديث: 20240411
DOI: 10.1002/jbmr.4913
PMID: 37718534
قاعدة البيانات: MEDLINE
الوصف
تدمد:1523-4681
DOI:10.1002/jbmr.4913