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Active Vitamin D and Accelerated Progression of Aortic Stiffness in Hemodialysis Patients: A Longitudinal Observational Study

BACKGROUND We hypothesized that high-dose active vitamin D therapy in the form of alphacalcidol (α-calcidol), used to treat secondary hyperparathyroidism in chronic kidney disease, could lead to vascular calcification and accelerated progression of aortic stiffness. METHODS We conducted an observati... Full description

Journal Title: American journal of hypertension 2014-11-01, Vol.27 (11), p.1346-1354
Main Author: Fortier, Catherine
Other Authors: Mac-Way, Fabrice , De Serres, Sacha A , Marquis, Karine , Douville, Pierre , Desmeules, Simon , Larivière, Richard , Agharazii, Mohsen
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Oxford University Press
ID: ISSN: 0895-7061
Link: https://www.ncbi.nlm.nih.gov/pubmed/24695980
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title: Active Vitamin D and Accelerated Progression of Aortic Stiffness in Hemodialysis Patients: A Longitudinal Observational Study
format: Article
creator:
  • Fortier, Catherine
  • Mac-Way, Fabrice
  • De Serres, Sacha A
  • Marquis, Karine
  • Douville, Pierre
  • Desmeules, Simon
  • Larivière, Richard
  • Agharazii, Mohsen
subjects:
  • Aged
  • Aged, 80 and over
  • Alfacalcidol
  • Aorta
  • aortic stiffness
  • Biomarkers - blood
  • Blood circulation disorders
  • Blood pressure
  • Bone diseases
  • Calcifediol
  • Calcifediol - administration & dosage
  • Calcifediol - adverse effects
  • Calcifediol - blood
  • Calcification
  • chronic kidney disease
  • Chronic kidney failure
  • Complications and side effects
  • Coronary vessels
  • Diet therapy
  • Dietary Supplements - adverse effects
  • Disease Progression
  • Drug Administration Schedule
  • Drug dosages
  • Female
  • Fibroblast Growth Factors - blood
  • Fibroblasts
  • Glucuronidase - blood
  • Growth factors
  • Health aspects
  • Hemodialysis
  • Humans
  • Hyperparathyroidism
  • Hyperparathyroidism, Secondary - blood
  • Hyperparathyroidism, Secondary - diagnosis
  • Hyperparathyroidism, Secondary - drug therapy
  • Hyperparathyroidism, Secondary - etiology
  • Hypertension
  • Kidney diseases
  • Linear Models
  • Longitudinal Studies
  • Male
  • Metabolism
  • Middle Aged
  • Mortality
  • Multivariate Analysis
  • Original
  • Original Article
  • parathyroid hormone
  • Parathyroid Hormone - blood
  • Quebec
  • Renal Dialysis - adverse effects
  • Renal Insufficiency, Chronic - blood
  • Renal Insufficiency, Chronic - complications
  • Renal Insufficiency, Chronic - diagnosis
  • Renal Insufficiency, Chronic - therapy
  • Risk Factors
  • Smooth muscle
  • Time Factors
  • Treatment Outcome
  • Vascular Diseases - blood
  • Vascular Diseases - chemically induced
  • Vascular Diseases - diagnosis
  • Vascular Diseases - physiopathology
  • Vascular Stiffness - drug effects
  • Vitamin D
  • Vitamin D - analogs & derivatives
  • Vitamin D - blood
  • α-calcidol
ispartof: American journal of hypertension, 2014-11-01, Vol.27 (11), p.1346-1354
description: BACKGROUND We hypothesized that high-dose active vitamin D therapy in the form of alphacalcidol (α-calcidol), used to treat secondary hyperparathyroidism in chronic kidney disease, could lead to vascular calcification and accelerated progression of aortic stiffness. METHODS We conducted an observational study in 85 patients on chronic hemodialysis, among which 70 were taking a weekly dose of α-calcidol of
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0895-7061
fulltext: fulltext
issn:
  • 0895-7061
  • 1879-1905
url: Link


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titleActive Vitamin D and Accelerated Progression of Aortic Stiffness in Hemodialysis Patients: A Longitudinal Observational Study
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creatorFortier, Catherine ; Mac-Way, Fabrice ; De Serres, Sacha A ; Marquis, Karine ; Douville, Pierre ; Desmeules, Simon ; Larivière, Richard ; Agharazii, Mohsen
creatorcontribFortier, Catherine ; Mac-Way, Fabrice ; De Serres, Sacha A ; Marquis, Karine ; Douville, Pierre ; Desmeules, Simon ; Larivière, Richard ; Agharazii, Mohsen
descriptionBACKGROUND We hypothesized that high-dose active vitamin D therapy in the form of alphacalcidol (α-calcidol), used to treat secondary hyperparathyroidism in chronic kidney disease, could lead to vascular calcification and accelerated progression of aortic stiffness. METHODS We conducted an observational study in 85 patients on chronic hemodialysis, among which 70 were taking a weekly dose of α-calcidol of <2 µg and 15 were taking a weekly dose of ≥2 µg (pharmacological dose). Parathyroid hormone, 25-hydroxyvitamin D, fibroblast growth factor 23, and α-klotho were determined. Aortic stiffness was assessed by determination of carotid-femoral pulse wave velocity (cf-PWV) at baseline and after a mean follow-up of 1.2 years. A multivariable regression model was used to evaluate the impact of pharmacological dose of α-calcidol on the progression of aortic stiffness. RESULTS At baseline, clinical, biological, and hemodynamic parameters were similar. At follow-up, cf-PWV increased more in patients with pharmacological dose of α-calcidol (0.583±2.291 m/s vs. 1.948±1.475 m/s; P = 0.04). After adjustment for changes in mean blood pressure and duration of follow-up, pharmacological dose of α-calcidol was associated with a higher rate of progression of cf-PWV (0.969 m/s; 95% confidence interval = 0.111-1.827; P = 0.03), and this association persisted after further adjustments for parameters of mineral metabolism. CONCLUSIONS In this study, pharmacological dose of α-calcidol was associated with accelerated progression of aortic stiffness. This study suggest that the vascular safety of active vitamin D posology may need to be specifically addressed in the treatment of chronic kidney disease-related bone mineral disorder.
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0ISSN: 0895-7061
1EISSN: 1879-1905
2DOI: 10.1093/ajh/hpu057
3PMID: 24695980
languageeng
publisherUnited States: Oxford University Press
subjectAged ; Aged, 80 and over ; Alfacalcidol ; Aorta ; aortic stiffness ; Biomarkers - blood ; Blood circulation disorders ; Blood pressure ; Bone diseases ; Calcifediol ; Calcifediol - administration & dosage ; Calcifediol - adverse effects ; Calcifediol - blood ; Calcification ; chronic kidney disease ; Chronic kidney failure ; Complications and side effects ; Coronary vessels ; Diet therapy ; Dietary Supplements - adverse effects ; Disease Progression ; Drug Administration Schedule ; Drug dosages ; Female ; Fibroblast Growth Factors - blood ; Fibroblasts ; Glucuronidase - blood ; Growth factors ; Health aspects ; Hemodialysis ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary - blood ; Hyperparathyroidism, Secondary - diagnosis ; Hyperparathyroidism, Secondary - drug therapy ; Hyperparathyroidism, Secondary - etiology ; Hypertension ; Kidney diseases ; Linear Models ; Longitudinal Studies ; Male ; Metabolism ; Middle Aged ; Mortality ; Multivariate Analysis ; Original ; Original Article ; parathyroid hormone ; Parathyroid Hormone - blood ; Quebec ; Renal Dialysis - adverse effects ; Renal Insufficiency, Chronic - blood ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - therapy ; Risk Factors ; Smooth muscle ; Time Factors ; Treatment Outcome ; Vascular Diseases - blood ; Vascular Diseases - chemically induced ; Vascular Diseases - diagnosis ; Vascular Diseases - physiopathology ; Vascular Stiffness - drug effects ; Vitamin D ; Vitamin D - analogs & derivatives ; Vitamin D - blood ; α-calcidol
ispartofAmerican journal of hypertension, 2014-11-01, Vol.27 (11), p.1346-1354
rights
0American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2014
1American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
2American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com
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0Fortier, Catherine
1Mac-Way, Fabrice
2De Serres, Sacha A
3Marquis, Karine
4Douville, Pierre
5Desmeules, Simon
6Larivière, Richard
7Agharazii, Mohsen
title
0Active Vitamin D and Accelerated Progression of Aortic Stiffness in Hemodialysis Patients: A Longitudinal Observational Study
1American journal of hypertension
addtitleAm J Hypertens
descriptionBACKGROUND We hypothesized that high-dose active vitamin D therapy in the form of alphacalcidol (α-calcidol), used to treat secondary hyperparathyroidism in chronic kidney disease, could lead to vascular calcification and accelerated progression of aortic stiffness. METHODS We conducted an observational study in 85 patients on chronic hemodialysis, among which 70 were taking a weekly dose of α-calcidol of <2 µg and 15 were taking a weekly dose of ≥2 µg (pharmacological dose). Parathyroid hormone, 25-hydroxyvitamin D, fibroblast growth factor 23, and α-klotho were determined. Aortic stiffness was assessed by determination of carotid-femoral pulse wave velocity (cf-PWV) at baseline and after a mean follow-up of 1.2 years. A multivariable regression model was used to evaluate the impact of pharmacological dose of α-calcidol on the progression of aortic stiffness. RESULTS At baseline, clinical, biological, and hemodynamic parameters were similar. At follow-up, cf-PWV increased more in patients with pharmacological dose of α-calcidol (0.583±2.291 m/s vs. 1.948±1.475 m/s; P = 0.04). After adjustment for changes in mean blood pressure and duration of follow-up, pharmacological dose of α-calcidol was associated with a higher rate of progression of cf-PWV (0.969 m/s; 95% confidence interval = 0.111-1.827; P = 0.03), and this association persisted after further adjustments for parameters of mineral metabolism. CONCLUSIONS In this study, pharmacological dose of α-calcidol was associated with accelerated progression of aortic stiffness. This study suggest that the vascular safety of active vitamin D posology may need to be specifically addressed in the treatment of chronic kidney disease-related bone mineral disorder.
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1Aged, 80 and over
2Alfacalcidol
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4aortic stiffness
5Biomarkers - blood
6Blood circulation disorders
7Blood pressure
8Bone diseases
9Calcifediol
10Calcifediol - administration & dosage
11Calcifediol - adverse effects
12Calcifediol - blood
13Calcification
14chronic kidney disease
15Chronic kidney failure
16Complications and side effects
17Coronary vessels
18Diet therapy
19Dietary Supplements - adverse effects
20Disease Progression
21Drug Administration Schedule
22Drug dosages
23Female
24Fibroblast Growth Factors - blood
25Fibroblasts
26Glucuronidase - blood
27Growth factors
28Health aspects
29Hemodialysis
30Humans
31Hyperparathyroidism
32Hyperparathyroidism, Secondary - blood
33Hyperparathyroidism, Secondary - diagnosis
34Hyperparathyroidism, Secondary - drug therapy
35Hyperparathyroidism, Secondary - etiology
36Hypertension
37Kidney diseases
38Linear Models
39Longitudinal Studies
40Male
41Metabolism
42Middle Aged
43Mortality
44Multivariate Analysis
45Original
46Original Article
47parathyroid hormone
48Parathyroid Hormone - blood
49Quebec
50Renal Dialysis - adverse effects
51Renal Insufficiency, Chronic - blood
52Renal Insufficiency, Chronic - complications
53Renal Insufficiency, Chronic - diagnosis
54Renal Insufficiency, Chronic - therapy
55Risk Factors
56Smooth muscle
57Time Factors
58Treatment Outcome
59Vascular Diseases - blood
60Vascular Diseases - chemically induced
61Vascular Diseases - diagnosis
62Vascular Diseases - physiopathology
63Vascular Stiffness - drug effects
64Vitamin D
65Vitamin D - analogs & derivatives
66Vitamin D - blood
67α-calcidol
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titleActive Vitamin D and Accelerated Progression of Aortic Stiffness in Hemodialysis Patients: A Longitudinal Observational Study
authorFortier, Catherine ; Mac-Way, Fabrice ; De Serres, Sacha A ; Marquis, Karine ; Douville, Pierre ; Desmeules, Simon ; Larivière, Richard ; Agharazii, Mohsen
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1Aged, 80 and over
2Alfacalcidol
3Aorta
4aortic stiffness
5Biomarkers - blood
6Blood circulation disorders
7Blood pressure
8Bone diseases
9Calcifediol
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11Calcifediol - adverse effects
12Calcifediol - blood
13Calcification
14chronic kidney disease
15Chronic kidney failure
16Complications and side effects
17Coronary vessels
18Diet therapy
19Dietary Supplements - adverse effects
20Disease Progression
21Drug Administration Schedule
22Drug dosages
23Female
24Fibroblast Growth Factors - blood
25Fibroblasts
26Glucuronidase - blood
27Growth factors
28Health aspects
29Hemodialysis
30Humans
31Hyperparathyroidism
32Hyperparathyroidism, Secondary - blood
33Hyperparathyroidism, Secondary - diagnosis
34Hyperparathyroidism, Secondary - drug therapy
35Hyperparathyroidism, Secondary - etiology
36Hypertension
37Kidney diseases
38Linear Models
39Longitudinal Studies
40Male
41Metabolism
42Middle Aged
43Mortality
44Multivariate Analysis
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46Original Article
47parathyroid hormone
48Parathyroid Hormone - blood
49Quebec
50Renal Dialysis - adverse effects
51Renal Insufficiency, Chronic - blood
52Renal Insufficiency, Chronic - complications
53Renal Insufficiency, Chronic - diagnosis
54Renal Insufficiency, Chronic - therapy
55Risk Factors
56Smooth muscle
57Time Factors
58Treatment Outcome
59Vascular Diseases - blood
60Vascular Diseases - chemically induced
61Vascular Diseases - diagnosis
62Vascular Diseases - physiopathology
63Vascular Stiffness - drug effects
64Vitamin D
65Vitamin D - analogs & derivatives
66Vitamin D - blood
67α-calcidol
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6Larivière, Richard
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issn0895-7061
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abstractBACKGROUND We hypothesized that high-dose active vitamin D therapy in the form of alphacalcidol (α-calcidol), used to treat secondary hyperparathyroidism in chronic kidney disease, could lead to vascular calcification and accelerated progression of aortic stiffness. METHODS We conducted an observational study in 85 patients on chronic hemodialysis, among which 70 were taking a weekly dose of α-calcidol of <2 µg and 15 were taking a weekly dose of ≥2 µg (pharmacological dose). Parathyroid hormone, 25-hydroxyvitamin D, fibroblast growth factor 23, and α-klotho were determined. Aortic stiffness was assessed by determination of carotid-femoral pulse wave velocity (cf-PWV) at baseline and after a mean follow-up of 1.2 years. A multivariable regression model was used to evaluate the impact of pharmacological dose of α-calcidol on the progression of aortic stiffness. RESULTS At baseline, clinical, biological, and hemodynamic parameters were similar. At follow-up, cf-PWV increased more in patients with pharmacological dose of α-calcidol (0.583±2.291 m/s vs. 1.948±1.475 m/s; P = 0.04). After adjustment for changes in mean blood pressure and duration of follow-up, pharmacological dose of α-calcidol was associated with a higher rate of progression of cf-PWV (0.969 m/s; 95% confidence interval = 0.111-1.827; P = 0.03), and this association persisted after further adjustments for parameters of mineral metabolism. CONCLUSIONS In this study, pharmacological dose of α-calcidol was associated with accelerated progression of aortic stiffness. This study suggest that the vascular safety of active vitamin D posology may need to be specifically addressed in the treatment of chronic kidney disease-related bone mineral disorder.
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