Active Vitamin D Use and Fractures in Hemodialysis Patients: Results from the International Dialysis Outcomes and Practice Patterns Study (DOPPS)
Authors' conclusion
Thus, our results do not suggest a PTH-independent benefit of active vitamin D in fracture prevention and support the current KDIGO guideline suggesting the use of active vitamin D only in subjects with elevated or rising PTH.
Study context
- Population
- In-center hemodialysis patients from 21 countries, DOPPS phases 3 to 6 (2005 to 2018); 55% prescribed active vitamin D at enrollment
- Participants
- 41,677 patients21 countries
- Exposure
- Active vitamin D prescribed vs not prescribed
- Outcome
- Incidence of any fracture and hip fracture
Methodological detailsinternational, multicentre, Cox regression adjusted for parathyroid hormone (PTH) and other potential confounders, per-protocol approach censoring at treatment switch, facility preference approach
- International
- Multicentre
- Cox regression adjusted for PTH and other potential confounders
- Per-protocol approach censoring at treatment switch
- Facility preference approach
Main finding
As reported in the abstract
Any fracture and hip fracture
Each group vs no active vitamin DEstimate (95% CI)
Active vitamin D
aHR (any fracture) 1.02(0.90–1.17)
Active vitamin D
aHR (hip fracture) 1.00(0.81–1.23)
- Event rate, any fracture (per patient-year, overall)
- 0.024
- Event rate, hip fracture (per patient-year, overall)
- 0.010
Observational data: associations, not effects.
Further findings
Fracture rate by facility preference (higher vs lower active vitamin D prescription)
- No difference in fracture rate between facilities with higher vs lower active vitamin D prescriptions
Original publication
Active Vitamin D Use and Fractures in Hemodialysis Patients: Results from the International DOPPS. J Bone Miner Res. Published 30 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →