Oral active vitamin D is associated with improved survival in hemodialysis patients

Kidney Int. 2008 Oct;74(8):1070-8. doi: 10.1038/ki.2008.343. Epub 2008 Jul 16.


Injection of active vitamin D is associated with better survival of patients receiving chronic hemodialysis. Since in many countries oral active vitamin D administration is the most common form of treatment for secondary hyperparathyroidism we determined the survival benefit of oral active vitamin D in hemodialysis patients from six Latin America countries (FME Register as part of the CORES study) followed for a median of 16 months. Time-dependent Cox regression models, after adjustment for potential confounders, showed that the 7,203 patients who received oral active vitamin D had significant reductions in overall, cardiovascular, infectious and neoplastic mortality compared to the 8,801 patients that had not received vitamin D. Stratified analyses found a survival advantage in the group that had received oral active vitamin D in 36 of the 37 strata studied including that with the highest levels of serum calcium, phosphorus and parathyroid hormone. The survival benefit of oral active vitamin D was seen in those patients receiving mean daily doses of less than 1 microg with the highest reduction associated with the lowest dose. Our study shows that hemodialysis patients receiving oral active vitamin D had a survival advantage inversely related to the vitamin dose.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Calcium / blood
  • Follow-Up Studies
  • Humans
  • Kidney Diseases / mortality
  • Kidney Diseases / therapy*
  • Latin America
  • Middle Aged
  • Parathyroid Hormone / blood
  • Phosphorus / blood
  • Registries
  • Renal Dialysis*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Vitamin D / administration & dosage*
  • Young Adult


  • Parathyroid Hormone
  • Vitamin D
  • Phosphorus
  • Calcium