The Protective Effect of Vitamin D on Dementia Risk in Hemodialysis Patients

Chih-Lang Lin; Wan-Ming Chen; An-Tzu Jao; Ben-Chang Shia; Szu-Yuan Wu

doi:10.3390/life13081741

The Protective Effect of Vitamin D on Dementia Risk in Hemodialysis Patients

Life (Basel). 2023 Aug 13;13(8):1741. doi: 10.3390/life13081741.

Authors

Chih-Lang Lin^{1

2

3}, Wan-Ming Chen^{4

5}, An-Tzu Jao⁶, Ben-Chang Shia^{4

5}, Szu-Yuan Wu^{4

5

6

7

8

9

10

11}

Affiliations

¹ Liver Research Unit, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Keelung 204, Taiwan.
² College of Medicine, Chang Gung University, Taoyuan 833, Taiwan.
³ Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung Branch, Keelung 204, Taiwan.
⁴ Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 242, Taiwan.
⁵ Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei 242, Taiwan.
⁶ Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁷ Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
⁸ Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁹ Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
¹⁰ Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
¹¹ Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.

Abstract

Background: Patients with end-stage renal disease (ESRD) undergoing hemodialysis are at an elevated risk of developing dementia, potentially linked to the high prevalence of vitamin D deficiency in this population, which may contribute to cognitive impairment. Nevertheless, the impact of vitamin D supplementation on the risk of dementia in hemodialysis patients remains uncertain, necessitating further investigation to elucidate the potential benefits of vitamin D intervention in this vulnerable group.

Methods: In this propensity-score-matched comparative cohort study, we sought to assess the impact of vitamin D supplementation on the occurrence of dementia in patients with end-stage renal disease (ESRD) undergoing hemodialysis. A total of 1424 patients were included and matched 1:1 using propensity scores. The study population was divided into two groups: those receiving vitamin D supplementation at a dose of ≥70 μg/week and those without any supplementation. The primary outcome of interest was the incidence of dementia. We calculated adjusted hazard ratios (aHRs) to examine the association between vitamin D supplementation and the risk of dementia while controlling for relevant covariates.

Results: The adjusted hazard ratio (aHR) comparing vitamin D supplementation to no supplementation was 0.44 (95% CI 0.29-0.69; p < 0.0001), demonstrating a significant decrease in the risk of dementia associated with vitamin D supplementation. The aHRs for vitamin D supplementation at different dose ranges (70-105, 106-350, 351-1000, and >1000 μg/week) were 0.51, 0.49, 0.43, and 0.41, respectively (p for trend < 0.0001). These findings suggest a potential dose-dependent relationship between vitamin D supplementation and the reduction of dementia risk.

Conclusions: In our study, we found that vitamin D supplementation at doses of ≥70 μg/week significantly reduced the risk of dementia in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Furthermore, our results indicated a dose-dependent effect, with higher doses of supplementation correlating with a greater reduction in dementia risk. These findings underscore the potential of vitamin D supplementation as a preventive approach for cognitive impairment in this high-risk population.

Keywords: Vitamin D; dementia; dose-dependent; hemodialysis; risk.

Grants and funding

Lo-Hsu Medical Foundation, LotungPoh-Ai Hospital, supports Szu-Yuan Wu’s work (Funding Number: 11001, 11010, 11013 and 11103). This research is supported by the Chang Gung Memorial Hospital Research Projects CLRPG2L0051.