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Active Vitamin D and Acute Respiratory Infections in Dialysis Patients
Authors:Yoshihiro Tsujimoto  Hideki Tahara  Tetsuo Shoji  Masanori Emoto  Hidenori Koyama  Eiji Ishimura  Tsutomu Tabata  Yoshiki Nishizawa  Masaaki Inaba
Affiliation:*Department of Internal Medicine, Inoue Hospital, Tokyo, Japan; ;Departments of Metabolism, Endocrinology, and Molecular Medicine and ;Nephrology, Osaka City University Graduate School of Medicine, Osaka, Japan; and ;§Osaka City University, Osaka, Japan
Abstract:

Summary

Background and objectives

Vitamin D has gained attention for its pleiotropic effects in areas other than bone metabolism, and the effects of vitamin D in preventing respiratory infections have been reported as one of its immunomodulating properties. This study assessed the preventive effect of vitamin D receptor activator (VDRA) on respiratory infections in dialysis patients.

Design, setting, participants, & measurements

Maintained Japanese hemodialysis patients (n = 508) were observed for 5 years, and the incidence of hospitalization during this period because of acute respiratory infection (ARI) was recorded.

Results:

Of the 508 patients, 212 had taken oral VDRA at the start of the study, whereas 296 patients had not received it. During the 5-year follow-up period, 57 patients were hospitalized because of ARIs. Kaplan–Meier analysis revealed that the incidence of hospitalization because of respiratory infection was significantly lower in patients who had been treated with VDRA compared with patients who had not (log rank test; P = 0.02). The multivariate Cox proportional hazards model demonstrated that the patients who had taken oral VDRA were at a significantly lower risk of hospitalization because of respiratory disease (hazard ratio 0.47, 95% confidence interval 0.25 to 0.90).

Conclusions:

The findings of this study suggest that the administration of oral VDRA has a preventive effect on the incidence of ARIs in dialysis patients.
Keywords:
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