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Düşük Serum 1,25-Dihidroksi Vitamin D Seviyesi Prevelan Hemodiyaliz Hastalarında Tüm Nedenli Mortalite Öngörücüsüdür

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Low Levels of 1.25-Dihydroxy Vitamin D is associated with All-cause Mortality in Prevalent Hemodialysis Patients

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Sayfa Aralığı:: 
11-16

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Abstract (Original Language): 
Vitamin D, kemik mineral metabolizması dışında da bir çok önemli fizyolojik süreçte rol oynamaktadır. İnsidan hemodiyaliz ve prediyaliz dönem hastalarda vitamin D düzeyi ile mortalite ilişkisi gösterilmiştir. Ancak prevelan hemodiyaliz hastalarında serum vitamin D düzeyi ile mortalite ilişkisi hakkında çok az veri vardır. Bu çalışmaya 545 prevelan hemodiyaliz hastası alındı. Hastaların bazal serum 25-Hidroksi ve 1,25- Dihidroksi vitamin D düzeyleri ve 2 yıl boyunca zamansal ortalamalı laboratuvar verileri belirlendi. Tüm nedenli mortalite, prospektif olarak bu 2 yıl sonunda incelendi. 25-Hidroksi vitamin D kadınlarda ve diyabetiklerde anlamlı olarak daha düşük saptandı. 1,25-Dihidroksi vitamin D de aynı şekilde diyabetiklerde anlamlı daha düşük saptandı. İki yıl sonunda, 25-Hidroksi ve 1,25-Dihidroksi vitamin D düzeyleri, prevelan hemoidiyaliz hastalarında tüm nedenli mortalite öngörücüsü olarak saptandı. Cox regresyon analizinde 1,25-Dihidroksi vitamin D düzeyi bağımsız tüm nedenli mortalite öngörücüsü olarak saptandı. Diyabetik olmayan prevelan hemodiyaliz hastalarında aktif vitamin D tedavisi modele eklendiğinde bile 1,25-Dihidroksi vitamin D düzeyi bağımsız tüm nedenli mortalite öngörücüsü idi. Serum 1,25-Dihidroksi vitamin D düzeyi prevelan hemodiyaliz hastalarında tüm nedenli mortalite öngörücüsüdür.
Abstract (2. Language): 
It has been suggested that vitamin D contributes not only to bone mineral metabolism but also to important other physiological processes. Vitamin D levels have been associated with increased mortality in predialysis and incident HD patients, but no data is available on the association between vitamin D levels and survival in prevalant hemodialysis (HD) patients. Five hundred and forty five prevalent hemodialysis patients were recruited. Time averaged laboratory values throughout the two years and base line serum 25-OH vitamin D and 1.25-OH vitamin D levels were determined. All-cause mortality was prospectively evaluated after 2-year follow-up period. 25- OH vitamin D levels were significantly lower in females and in patients with diabetes. 1.25-OH2 vitamin D level was significantly lower in diabetics. After two years of follow-up period, in crude analysis low serum 25-OH and 1.25 OH2 vitamin D levels were associated with all cause mortality. In adjusted Cox-regression analysis, 1.25-OH2 vitamin D level, but not 25-OH, was found as an independent predictor for all-cause mortality. Low 1.25-OH2 vitamin D level was also found as an independent predictor for all-cause mortality in non-diabetic study group even after inclusion of time averaged vitamin Dtherapy dosage. Serum 1.25-OH vitamin D level is associated with all cause mortality in prevalant hemodialysis patients.

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DOI: 
10.5262/tndt.2010.1001.01

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