Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
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- dc.contributor.author Arenas Jiménez, María Dolores
- dc.contributor.author Riera Oliva, Marta
- dc.contributor.author Cao Baduell, Higinio
- dc.contributor.author Collado Nieto, Silvia
- dc.contributor.author Barbosa Puig, Francisco
- dc.contributor.author Nogués Solan, Francesc Xavier
- dc.contributor.author Crespo, Marta
- dc.contributor.author Pascual Santos, Julio
- dc.date.accessioned 2022-07-05T06:24:02Z
- dc.date.available 2022-07-05T06:24:02Z
- dc.date.issued 2021
- dc.description.abstract 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.
- dc.format.mimetype application/pdf
- dc.identifier.citation Arenas Jimenez MD, González-Parra E, Riera M, Rincón Bello A, López-Herradón A, Cao H, et al. Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics. Nutrients. 2021 Jul 26; 13(8): 2559. DOI: 10.3390/nu13082559
- dc.identifier.doi http://dx.doi.org/10.3390/nu13082559
- dc.identifier.issn 2072-6643
- dc.identifier.uri http://hdl.handle.net/10230/53674
- dc.language.iso eng
- dc.publisher MDPI
- dc.rights This 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.
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by/4.0/
- dc.subject.keyword COVID-19
- dc.subject.keyword SARS-CoV-2
- dc.subject.keyword Calcifediol
- dc.subject.keyword Calcitriol
- dc.subject.keyword Survival
- dc.subject.keyword Vitamin D
- dc.title Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion