Vitamin D and cinacalcet are associated with increased survival in peritoneal dialysis but not with residual renal function preservation .

Abstract

Active vitamin D and cinacalcet, a treatment for secondary hyperparathyroidism and also with potential anti-inflammatory properties, have been associated with lower risk of death among dialysis patients. Vitamin D has also been described to decrease proteinuria in CKD patients. This study aims to assess the relationship of vitamin D and cinacalcet with survival and residual renal function preservation among peritoneal dialysis patients. In a retrospective peritoneal dialysis cohort of 581 subjects, we assessed if vitamin D and cinacalcet therapy are associated with increased risk of death and residual renal function loss using Kaplan-Meier analysis and Cox proportional hazard analysis. Vitamin D treatment was associated with a 56% reduction in the risk of death (HR 0.44, 95% CI 0.28-0.67) and cinacalcet also with a 54% lower risk of death (HR 0.46, 95% CI 0.31-0.69) in multivariate models adjusting for each other. Hyperphosphatemia (> 6 mg/dL) was associated with an 85% increase in mortality (HR 1.85, 95% CI 1.30-2.65). Neither vitamin D (HR 1.04, 95% CI 0.45-2.39) nor cinacalcet (HR 0.74, 95% CI 0.45-1.20) were associated with a lower risk of anuria. Vitamin D and cinacalcet therapy was associated with a lower risk of death but not anuria, beyond other known risk factors among peritoneal dialysis patients. .