Effect of Alfacalcidol Therapy on the Survival of Chronic Hemodialysis Patients
Article first published online: 21 MAR 2012
© 2012 The Authors. Therapeutic Apheresis and Dialysis © 2012 International Society for Apheresis
Therapeutic Apheresis and Dialysis
Volume 16, Issue 3, pages 248–253, June 2012
How to Cite
Ogawa, M., Ogawa, T., Inoue, T., Otsuka, K. and Nitta, K. (2012), Effect of Alfacalcidol Therapy on the Survival of Chronic Hemodialysis Patients. Therapeutic Apheresis and Dialysis, 16: 248–253. doi: 10.1111/j.1744-9987.2012.01061.x
- Issue published online: 21 MAY 2012
- Article first published online: 21 MAR 2012
- Received August 2011; revised November 2011.
- Mineral metabolism;
- Survival rate;
- Vitamin D
The aim of this study was to determine the relationship between alfacalcidol therapy and the outcomes of chronic hemodialysis (HD) patients. We collected demographic and clinical baseline data from 190 prevalent HD patients in a regional Japanese cohort. A 5-year survival analysis was performed according to whether the patients were receiving calcitriol analog therapy. Alfacalcidol therapy at a mean dose of 5.2 ± 1.8 µg/week was performed in 89 (46.8%) of the 190 patients. We recorded 38 deaths during the follow-up period, including 19 deaths from cardiovascular events. A Kaplan–Meier analysis demonstrated that the alfacalcidol users had a significantly lower rate of all-cause mortality and cardiovascular mortality than the non-users. According to a multivariate Cox proportional hazards model, in addition to the use of alfacalcidol (HR=0.347 [0.155–0.714]; P = 0.0035), serum CRP levels (HR= 1.746 [1.184–2.442]; P = 0.0071) and non-HDL-cholesterol levels (HR=1.012 [1.001–1.022]; P = 0.0267) were identified as independent predictors of all-cause mortality, and the presence of diabetes mellitus (HR=3.720 [1.182–12.398]; P = 0.0246) was identified as an independent predictor of cardiovascular mortality. These findings suggest that low-dose alfacalcidol therapy provides a survival advantage to chronic HD patients.