Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics

Background: In COVID-19 patients, low serum vitamin D (VD) levels have been associated with severe acute respiratory failure and poor prognosis. In regular hemodialysis (HD) patients, there is VD deficiency and markedly reduced calcitriol levels, which may predispose them to worse outcomes of COVID-...

Descripción completa

Detalles Bibliográficos
Autores: Arenas, María Dolores (Arenas Jiménez), Riera Oliva, Marta, Cao Baduell, Higinio, Collado, Silvia, Barbosa Puig, Francisco, Nogués Solán, Xavier, Crespo Barrio, Marta, Pascual Santos, Julio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/53674
Acceso en línea:http://hdl.handle.net/10230/53674
http://dx.doi.org/10.3390/nu13082559
Access Level:acceso abierto
Palabra clave:COVID-19
SARS-CoV-2
Calcifediol
Calcitriol
Survival
Vitamin D
id ES_bceeb8e2b3a0582aa4d42c586c58afc0
oai_identifier_str oai:repositori.upf.edu:10230/53674
network_acronym_str ES
network_name_str España
repository_id_str
spelling Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimeticsArenas, María Dolores (Arenas Jiménez)Riera Oliva, MartaCao Baduell, HiginioCollado, SilviaBarbosa Puig, FranciscoNogués Solán, XavierCrespo Barrio, MartaPascual Santos, JulioCOVID-19SARS-CoV-2CalcifediolCalcitriolSurvivalVitamin DBackground: In COVID-19 patients, low serum vitamin D (VD) levels have been associated with severe acute respiratory failure and poor prognosis. In regular hemodialysis (HD) patients, there is VD deficiency and markedly reduced calcitriol levels, which may predispose them to worse outcomes of COVID-19 infection. Some hemodialysis patients receive treatment with drugs for secondary hyperparathyroidism, which have well known pleiotropic effects beyond mineral metabolism. The aim of this study was to evaluate the impact of VD status and the administration of active vitamin D medications, used to treat secondary hyperparathyroidism, on survival in a cohort of COVID-19 positive HD patients. Methods: A cross-sectional retrospective observational study was conducted from 12 March to 21 May 2020 in 288 HD patients with positive PCR for SARS-CoV2. Patients were from 52 different centers in Spain. Results: The percent of HD patients with COVID-19 was 6.1% (288 out of 4743). Mortality rate was 28.4% (81/285). Three patients were lost to follow-up. Serum 25(OH)D (calcidiol) level was 17.1 [10.6-27.5] ng/mL and was not significantly associated to mortality (OR 0.99 (0.97-1.01), p = 0.4). Patients receiving active vitamin D medications (16/94 (17%) vs. 65/191(34%), p = 0.003), including calcimimetics (4/49 (8.2%) vs. 77/236 (32.6%), p = 0.001), paricalcitol or calcimimetics (19/117 (16.2%) vs. 62/168 (36.9%); p < 0.001), and also those on both paricalcitol and calcimimetics, to treat secondary hyperparathyroidism (SHPTH) (1/26 (3.8%) vs. 80/259 (30.9%), p < 0.001) showed a lower mortality rate than patients receiving no treatment with either drug. Multivariate Cox regression analysis confirmed this increased survival. Conclusions: Our findings suggest that the use of paricalcitol, calcimimetics or the combination of both, seem to be associated with the improvement of survival in HD patients with COVID-19. No correlation was found between serum VD levels and prognosis or outcomes in HD patients with COVID-19. Prospective studies and clinical trials are needed to support these findings.MDPI202220222021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/53674http://dx.doi.org/10.3390/nu13082559reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésThis is an open access article distributed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/536742026-06-12T07:21:37Z
dc.title.none.fl_str_mv Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
title Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
spellingShingle Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
Arenas, María Dolores (Arenas Jiménez)
COVID-19
SARS-CoV-2
Calcifediol
Calcitriol
Survival
Vitamin D
title_short Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
title_full Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
title_fullStr Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
title_full_unstemmed Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
title_sort Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
dc.creator.none.fl_str_mv Arenas, María Dolores (Arenas Jiménez)
Riera Oliva, Marta
Cao Baduell, Higinio
Collado, Silvia
Barbosa Puig, Francisco
Nogués Solán, Xavier
Crespo Barrio, Marta
Pascual Santos, Julio
author Arenas, María Dolores (Arenas Jiménez)
author_facet Arenas, María Dolores (Arenas Jiménez)
Riera Oliva, Marta
Cao Baduell, Higinio
Collado, Silvia
Barbosa Puig, Francisco
Nogués Solán, Xavier
Crespo Barrio, Marta
Pascual Santos, Julio
author_role author
author2 Riera Oliva, Marta
Cao Baduell, Higinio
Collado, Silvia
Barbosa Puig, Francisco
Nogués Solán, Xavier
Crespo Barrio, Marta
Pascual Santos, Julio
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
SARS-CoV-2
Calcifediol
Calcitriol
Survival
Vitamin D
topic COVID-19
SARS-CoV-2
Calcifediol
Calcitriol
Survival
Vitamin D
description Background: In COVID-19 patients, low serum vitamin D (VD) levels have been associated with severe acute respiratory failure and poor prognosis. In regular hemodialysis (HD) patients, there is VD deficiency and markedly reduced calcitriol levels, which may predispose them to worse outcomes of COVID-19 infection. Some hemodialysis patients receive treatment with drugs for secondary hyperparathyroidism, which have well known pleiotropic effects beyond mineral metabolism. The aim of this study was to evaluate the impact of VD status and the administration of active vitamin D medications, used to treat secondary hyperparathyroidism, on survival in a cohort of COVID-19 positive HD patients. Methods: A cross-sectional retrospective observational study was conducted from 12 March to 21 May 2020 in 288 HD patients with positive PCR for SARS-CoV2. Patients were from 52 different centers in Spain. Results: The percent of HD patients with COVID-19 was 6.1% (288 out of 4743). Mortality rate was 28.4% (81/285). Three patients were lost to follow-up. Serum 25(OH)D (calcidiol) level was 17.1 [10.6-27.5] ng/mL and was not significantly associated to mortality (OR 0.99 (0.97-1.01), p = 0.4). Patients receiving active vitamin D medications (16/94 (17%) vs. 65/191(34%), p = 0.003), including calcimimetics (4/49 (8.2%) vs. 77/236 (32.6%), p = 0.001), paricalcitol or calcimimetics (19/117 (16.2%) vs. 62/168 (36.9%); p < 0.001), and also those on both paricalcitol and calcimimetics, to treat secondary hyperparathyroidism (SHPTH) (1/26 (3.8%) vs. 80/259 (30.9%), p < 0.001) showed a lower mortality rate than patients receiving no treatment with either drug. Multivariate Cox regression analysis confirmed this increased survival. Conclusions: Our findings suggest that the use of paricalcitol, calcimimetics or the combination of both, seem to be associated with the improvement of survival in HD patients with COVID-19. No correlation was found between serum VD levels and prognosis or outcomes in HD patients with COVID-19. Prospective studies and clinical trials are needed to support these findings.
publishDate 2021
dc.date.none.fl_str_mv 2021
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/53674
http://dx.doi.org/10.3390/nu13082559
url http://hdl.handle.net/10230/53674
http://dx.doi.org/10.3390/nu13082559
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869418157423198208
score 15.198674

Similares en LA Referencia