Abstract: TH-PO837
Higher 25-Hydroxyvitamin D Associates With Gastrointestinal Bleeding Events
Session Information
- Health Maintenance, Nutrition, Metabolism
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance‚ Nutrition‚ and Metabolism
- 1400 Health Maintenance‚ Nutrition‚ and Metabolism
Authors
- Larkin, John W., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
- Jiao, Yue, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
- Lama, Suman Kumar, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
- Chaudhuri, Sheetal, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
- Willetts, Joanna, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
- Winter, Anke, Fresenius Medical Care, Global Medical Office, Bad Homburg, Germany
- Stauss-Grabo, Manuela, Fresenius Medical Care, Global Medical Office, Bad Homburg, Germany
- Usvyat, Len A., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
- Hymes, Jeffrey L., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
- Maddux, Franklin W., Fresenius Medical Care AG & Co KGaA, Bad Homburg, Hessen, Germany
- Stenvinkel, Peter, Karolinska Institutet, Stockholm, Sweden
- Floege, Jürgen, University Hospital Aachen, Division of Nephrology and Clinical Immunology, Aachen, Germany
Group or Team Name
- on behalf of the INSPIRE Core Group
Background
In an effort within the INSPIRE collaboration, we built a gastrointestinal (GI) bleed hospitalization risk model and unexpectedly found higher serum 25 hydroxyvitamin D concentration (25OH Vit D) was one of the most predictive factors in hemodialysis (HD). To investigate this signal, we assessed all-cause and GI bleed hospitalization rates by 25OH Vit D levels.
Methods
We used data from adult HD patients in the United States with ≥1 25OH Vit D lab during Jan 2016-Dec 2020. We calculated % patients with ≥1 all-cause or GI bleed admission within 180 days after a 25OH Vit D lab by groups (<15, ≥15 to <30, ≥30 to <50, ≥50 to <60, ≥60 ng/mL).
Results
Among 225,459 patients (mean age 63.1 years, 57.4% male, 56.2% white race & HD vintage 3.3 years), those with 25OH Vit D <15 ng/mL had the highest all-cause, yet the lowest GI bleed, admission rates (Figure 1). Patients with 25OH Vit D ≥30 to <50 and ≥50 to <60 ng/mL had the lowest all-cause and highest GI bleed admission rates. Patients with 25OH Vit D >60 ng/mL had a higher all-cause admission rate than the ≥30 to <50 and ≥50 to <60 ng/mL groups, and a GI bleed admission rate slightly lower than the ≥30 to <50 ng/mL group.
Conclusion
We found an inverse association between all-cause and GI bleed admission rates based on 25OH Vit D levels. It appears 25OH Vit D >30 ng/mL may associate with GI bleeding events in HD patients, with the highest event rates at ≥50 to <60 ng/mL, which is consistent with findings at in warfarin users without kidney failure (Keskin U, 2019). Albeit hypothetical, extremely high 25OH Vit D >60 ng/mL might be representative of specific comorbidities that explain the all-cause admission rates in this group. Given the higher recommendations for 25OH Vit D in kidney disease (≥30 ng/mL) versus general population (≥20 to <30 ng/mL), further adjusted analysis accounting for competing risks are needed.
Funding
- Commercial Support – Fresenius Medical Care