Significance of 1,25-Dihydroxyvitamin D3 on Overall Mortality in Peritoneal Dialysis Patients with COVID-19

Nutrients. 2023 Apr 24;15(9):2050. doi: 10.3390/nu15092050.

Abstract

In previous publications, we pointed out the importance of mannosylation of fibrinogen for the development of cardiovascular complications and fucosylation as a predictor of peritoneal membrane dysfunction in patients on peritoneal dialysis (PD). After a follow-up period of 30 months from the onset of the COVID-19 pandemic, we evaluated the significance of 1,25-dihydroxyvitamin D3 (calcitriol) therapy, primary disease, biochemical and hematologic analyzes, and previously performed glycan analysis by lectin-based microarray as predictors of mortality in this patient group. After univariate Cox regression analysis, diabetes mellitus (DM) and calcitriol therapy were found to be potential predictors of mortality. Additional multivariate Cox regression analysis confirmed that only DM was a predictor of mortality. Nevertheless, the use of calcitriol in therapy significantly reduced mortality in this patient group, as shown by the Kaplan-Meier survival curve. The presence of DM as a concomitant disease proved to be a strong predictor of fatal outcome in PD patients infected with SARS-CoV-2. This is the first study to indicate the importance and beneficial effect of calcitriol therapy on survival in PD patients with COVID-19 infection. In addition, this study points to the possibility that adverse thrombogenic events observed in PD patients during the pandemic may be caused by aberrant fibrinogen glycosylation.

Keywords: COVID-19; calcitriol; glycosylation; mortality; peritoneal dialysis.

MeSH terms

  • COVID-19*
  • Calcitriol
  • Fibrinogen
  • Hemostatics*
  • Humans
  • Pandemics
  • Peritoneal Dialysis* / adverse effects
  • SARS-CoV-2

Substances

  • 1,25-dihydroxyvitamin D
  • Calcitriol
  • Fibrinogen
  • Hemostatics

Grants and funding

This work was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (Grant no. 451-03-47/2023-01/200019) and Bilateral Cooperation project with the Republic of Slovakia (Grant no. 337-00-107/2019-09/12), grant APVV SK-SRB-21-0046, grant VEGA 2/0120/22 and grant APVV-20-0243. This publication is the result of the project implementation CEMBAM—Centre for Medical Bio-Additive Manufacturing and Research, ITMS2014+: 313011V358 supported by the Operational Programme Integrated Infrastructure funded by the European Regional Development Fund.