Shen Beili, Liu Bianling, Wang Yanhui, Wang Rui, Gu Dongfeng
The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, Henan, 450003, People's Republic of China.
Int J Gen Med. 2024 Nov 9;17:5153-5162. doi: 10.2147/IJGM.S477114. eCollection 2024.
Deficiency in vitamin D is associated with adverse outcomes in several health conditions. However, the specific impact of vitamin D levels on mortality in acute kidney injury (AKI) patients remains inadequately explored. This study aims to investigate the association between serum vitamin D concentrations and mortality risk in critically ill patients diagnosed with AKI. We hypothesize that severe vitamin D deficiency is associated with an increased risk of 90-day all-cause mortality in these patients.
This study retrospectively enrolled 259 adult AKI patients admitted to the intensive care unit (ICU) at The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital) between July 2021 and June 2023. Based on 25-hydroxyvitamin D (25-OHD) levels, they were categorized into 4 groups: severe deficiency (<10 ng/mL), deficiency (10-20 ng/mL), insufficiency (20-30 ng/mL), and sufficiency (>30 ng/mL). Multivariate survival analysis using Cox's regression model was used to analyze the impact of vitamin D concentrations on the 90-day all-cause mortality risk after controlling for potential confounders.
The 90-day all-cause mortality rate was the highest in patients with severe deficiency (50.8%), followed by those with deficiency (35.0%), insufficiency (23.9%), and sufficiency (12.2%). Multivariate Cox regression showed that compared with sufficiency, severe deficiency (HR=3.34, 95% CI: 1.14-9.77; =0.03) was independently associated with a higher risk of 90-day all-cause mortality, but deficiency and insufficiency were not significantly associated with 90-day all-cause mortality risk.
Severe vitamin D deficiency (<10 ng/mL) significantly increases the risk of mortality in AKI patients, underlining the need for monitoring and potentially supplementing vitamin D in this population.
维生素D缺乏与多种健康状况下的不良结局相关。然而，维生素D水平对急性肾损伤（AKI）患者死亡率的具体影响仍未得到充分研究。本研究旨在探讨血清维生素D浓度与诊断为AKI的危重症患者死亡风险之间的关联。我们假设严重维生素D缺乏与这些患者90天全因死亡率风险增加相关。
本研究回顾性纳入了2021年7月至2023年6月期间在河南中医药大学第五临床医学院（郑州市人民医院）重症监护病房（ICU）收治的259例成年AKI患者。根据25-羟基维生素D（25-OHD）水平，将他们分为4组：严重缺乏（<10 ng/mL）、缺乏（10 - 20 ng/mL）、不足（20 - 30 ng/mL）和充足（>30 ng/mL）。在控制潜在混杂因素后，使用Cox回归模型进行多因素生存分析，以分析维生素D浓度对90天全因死亡风险的影响。
严重缺乏组患者的90天全因死亡率最高（50.8%），其次是缺乏组（35.0%）、不足组（23.9%）和充足组（12.2%）。多因素Cox回归显示，与充足组相比，严重缺乏组（HR = 3.34，95% CI：1.14 - 9.77；P = 0.03）独立与90天全因死亡风险较高相关，但缺乏组和不足组与90天全因死亡风险无显著关联。
严重维生素D缺乏（<10 ng/mL）显著增加AKI患者的死亡风险，强调了对该人群监测和可能补充维生素D的必要性。
