Abstract

Background: Active vitamin D and cinacalcet, a treatment for secondary hyperparathyroidism and also with potential anti-inflammatory properties, have been associated with lower risk of death among dialysis patients. Vitamin D has also been described to decrease proteinuria in CKD patients. This study aims to assess the relationship of vitamin D and cinacalcet with survival and residual renal function preservation among peritoneal dialysis patients. Materials and methods: In a retrospective peritoneal dialysis cohort of 581 subjects, we assessed if vitamin D and cinacalcet therapy are associated with increased risk of death and residual renal function loss using Kaplan-Meier analysis and Cox proportional hazard analysis. Results: Vitamin D treatment was associated with a 56% reduction in the risk of death (HR 0.44, 95% CI 0.28 – 0.67) and cinacalcet also with a 54% lower risk of death (HR 0.46, 95% CI 0.31 – 0.69) in multivariate models adjusting for each other. Hyperphosphatemia (> 6 mg/dL) was associated with an 85% increase in mortality (HR 1.85, 95% CI 1.30 – 2.65). Neither vitamin D (HR 1.04, 95% CI 0.45 – 2.39) nor cinacalcet (HR 0.74, 95% CI 0.45 – 1.20) were associated with a lower risk of anuria. Conclusion: Vitamin D and cinacalcet therapy was associated with a lower risk of death but not anuria, beyond other known risk factors among peritoneal dialysis patients.


Author Details

Authors

• Susie L. Hu¹
• Priyanka Joshi²
• Mark Kaplan³
• Judy Lefkovitz⁴
• Dominique S. Michaud^{2, 5}

Departments

• ¹ Division of Kidney Disease and Hypertension, Department of Medicine, Warren Alpert Medical School of Brown University,
• ² Department of Epidemiology, School of Public Health, Brown University, Rhode Island Hospital, Providence, RI, 

• ³ Medical Affairs, DaVita Healthcare Partners, Inc.,
• ⁴ Information Technology, DSI Renal and U.S. Renal Care, Inc., Nashville, TN, and
• ⁵ Department of Public Health and Community Medicine, Tufts University Medical School, Boston, MA, USA

Address

Susie L. Hu, MD

Division of Kidney Disease and Hypertension
Department of Medicine
Warren Alpert Medical School of Brown University
Rhode Island Hospital
593 Eddy Street, APC 9, Providence, RI 02903, USA

Email: [email protected]

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