Abstract: PO0596
Oral Calcitriol Use, Vertebral Fractures, and Vascular Calcifications in Hemodialysis Patients: Results from the Vitamin K Italian (VIKI) Study
Session Information
- Vascular Disease, Nephrolithiasis, and Mineral Metabolism: Clinical
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Fusaro, Maria, National Research Council (CNR) – Institute of Clinical Physiology (IFC), Pisa, Italy
- Aghi, Andrea, Department of Medicine, University of Padova, Padova, Italy
- Politi, Cristina, CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
- Nickolas, Thomas, Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States
- Khairallah, Pascale, Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States
- Gallieni, Maurizio, Nephrology and Dialysis Unit, Azienda Socio-Sanitaria Territoriale (ASST) Fatebenefratelli Sacco, Department of Clinical and Biomedical Sciences 'Luigi Sacco', Università di Milano, Milano, Italy
- Mereu, Maria cristina Mc, Independent Research, Cagliari, Italy
- Tripepi, Giovanni, CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Ospedali Riuniti, Reggio Calabria, Italy
Background
Chronic Kidney Disease patients are characterized by alterations in bone and vascular metabolism associated to adverse clinical outcomes such as fractures, cardiovascular events and mortality. Dysregulation of vitamin D hormonal system, in levels of calcium, phosphate, PTH, FGF23/Klotho are the main responsible of these changes. We want to evaluate if oral calcitriol use can play a protective role on fractures in hemodialysis (HD) patients.
Methods
We included 387 HD patients of the VIKI database, a multicenter cross-sectional study. Biomarkers measured: vitamin K, VKDPs, vitamin 25(OH) D, ALP, PTH, Ca, P. Spine radiograph performed to define the presence of Vertebral Fractures (VF) and Vascular Calcification (VC). VF was indicated as >20% reduction of vertebral body height and VCs were quantified by measuring the length of calcium deposits along the arteries.
Results
45.7% of patients were treated with oral calcitriol. No biochemical differences was observed between the treated and untreated patients. VFs were significantly lower in patients receiving oral calcitriol (48.6% vs 61%, P=0.015), the presence of VCs was similar (aortic: 81.9% vs 79.5% respectively, P=0.552; iliac: 52.0% and 59.5%, P=0.167). In a multivariable logistic regression analysis, after adjustment for all potential confounders, oral calcitriol was associated with a marked reduction (-40.2%) of the odds of fractures (OR: 0.598, 95% CI: 0.363-0.985, P=0.043).
Conclusion
In conclusion, we found a significant association between oral calcitriol use and lower VF rate in HD patients. Further prospective and interventional studies are needed to confirm these findings.
Funding
- Private Foundation Support