Division of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan.
College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
Sci Rep. 2020 May 5;10(1):7533. doi: 10.1038/s41598-020-64359-9.
Hemodialysis patients are a special group of patients with higher mortality rates. Hemodialysis patients with vitamin D deficiency {plasma levels of 25-hydroxyvitamin D [25(OH)D] below 20 ng/mL} are associated with even higher mortality rates. The prognostic importance of vitamin D deficiency in hemodialysis patients with different cardiothoracic ratios (CTRs) is still unclear. This prospective study was performed in a single hemodialysis center, and 186 patients were included. This study analyzed the prognostic importance of vitamin D deficiency in hemodialysis patients with different CTRs. Vitamin D deficiency patients had a significantly higher prevalence of stroke and diabetic mellitus than those without vitamin D deficiency. In addition, the CTR was higher in patients with vitamin D deficiency than in those without vitamin D deficiency. After multivariate logistic regression, we found that CTR was the solitary factor that was independently significantly associated with vitamin D deficiency [odds ratio: 1.07, 95% confidence internal (CI): 1.01-1.13, p = 0.02]. Additionally, vitamin D deficiency was associated with all-cause mortality in patients with higher CTR after adjustment in hierarchical regression models. In conclusion, we reported that vitamin D deficiency was independently significantly associated with a higher CTR. We additionally revealed that vitamin D deficiency was an independent predicator for all-cause mortality in higher CTR hemodialysis patients.
血液透析患者是死亡率较高的特殊患者群体。维生素 D 缺乏症（血液 25-羟维生素 D [25(OH)D]水平低于 20ng/mL）的血液透析患者死亡率更高。不同心胸比（CTR）的血液透析患者中维生素 D 缺乏的预后意义尚不清楚。本前瞻性研究在单一血液透析中心进行，共纳入 186 例患者。本研究分析了不同 CTR 的血液透析患者维生素 D 缺乏的预后意义。维生素 D 缺乏症患者的中风和糖尿病患病率明显高于非维生素 D 缺乏症患者。此外，维生素 D 缺乏症患者的 CTR 高于非维生素 D 缺乏症患者。经过多变量逻辑回归，我们发现 CTR 是唯一与维生素 D 缺乏症独立显著相关的因素[比值比：1.07，95%置信区间（CI）：1.01-1.13，p=0.02]。此外，在分层回归模型中调整后，维生素 D 缺乏症与较高 CTR 患者的全因死亡率相关。总之，我们报告维生素 D 缺乏症与较高的 CTR 独立显著相关。我们还发现，维生素 D 缺乏症是较高 CTR 血液透析患者全因死亡率的独立预测因子。
