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Dialysis patients can live longer

A new form of vitamin D, called paricalcitol, may help people with kidney failure live longer, according to recent research.

Dialysis patients can live longer

A new form of vitamin D, called paricalcitol, may help people with kidney failure live longer, according to recent research. Vitamin D plays an important role in controlling levels of calcium and phosphorus in the blood. In order to do this, however, vitamin D must be "activated" or chemically altered by the kidneys. People with kidney failure have problems activating their vitamin D, so, as a consequence, their calcium and phosphorus levels are abnormal. To overcome this problem, an activated form of vitamin D, known as calcitriol, is typically given to these patients. Unfortunately, there is concern that this may lead to high levels of calcium and phosphorus that hasten death. Paricalcitol also raises these levels, but to a lesser extent, and could, therefore, improve patient survival.Researchers from the Massachusetts General Hospital in Boston studied more than 65,000 kidney failure patients who had been undergoing dialysis for many years. Between 1999 and 2001, these patients were treated with paricalcitol or calcitriol. It was found that patients who received paricalcitol had a 16 percent better chance of survival than those who received calcitriol. As expected, calcium and phosphorus levels increased to a much lesser extent in the paricalcitol group compared with the calcitriol group.
According to the researchers this is the first evidence that a specific form of vitamin D can improve survival among dialysis patients. However, the mechanism behind this improved survival needs to be investigated as this could give more knowledge about how vitamin D is really working and how it might apply these findings to patients before they start dialysis, as well as those who undergo a kidney transplant.

The New England Journal of Medicine, July 2003
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