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ORIGINAL RESEARCH article

Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1453522
This article is part of the Research Topic Vitamin D: From Pathophysiology to Clinical Impact Volume II View all 22 articles

Vitamin D supplementation may be beneficial in improving the prognosis of patients with sepsis-associated acute kidney injury in the intensive care unit: a retrospective study

Provisionally accepted
Jie Sun Jie Sun 1Yan Wang Yan Wang 2Jue Wang Jue Wang 1Hongwei Wu Hongwei Wu 1Zhefeng Xu Zhefeng Xu 1Dongsheng Niu Dongsheng Niu 1*
  • 1 Department of Emergency Medicine ,Jincheng People's Hospital, Jincheng, China, Jincheng, China
  • 2 Department of Pulmonary and Critical Care Medicine, Jincheng General Hospital, Jincheng, China

The final, formatted version of the article will be published soon.

    Background: Vitamin D, a vital fat-soluble micronutrient, plays essential roles in calcium homeostasis, immune regulation, and resistance to infections. Research indicates a link between low vitamin D levels and negative outcomes in critically ill patients, particularly those with acute kidney injury (AKI). This study aimed to explore the correlation between vitamin D supplementation during ICU admission and clinical outcomes in patients with severe AKI. Methods: We analyzed data from the Medical Information Mart for Intensive Care IV (MIMIC-IV), focusing on patients with sepsis-associated acute kidney injury (SA-AKI). Participants were divided into two groups: those who received vitamin D supplementation and those who did not. We assessed in-hospital mortality using Kaplan-Meier survival curves and Cox proportional hazards regression, applying propensity score matching (PSM) to mitigate bias. Secondary outcomes included 28-day and 90-day mortality rates, along with norepinephrine-free days at 28 days. Results: Our cohort comprised 11,896 SA-AKI patients, with 2,724 receiving vitamin D. Kaplan-Meier analysis revealed significant survival differences, and Cox regression showed a reduced risk of in-hospital mortality in the vitamin D group (adjusted risk ratio: 0.56, 95% CI: 0.5-0.63). These results were consistent across PSM and various analytical methods, with hazard ratios between 0.53 and 0.59 (p < 0.001). E-value analyses confirmed the robustness of findings against unmeasured confounders. Conclusions: This study indicates that vitamin D supplementation may lower in-hospital mortality rates in SA-AKI patients in the ICU, with additional benefits observed in 28-day and 90-day mortality rates and norepinephrine-free days.

    Keywords: ：Vitamin D supplementation, Mortality, SA-AKI, MIMIC-IV, Intensive Care Unit

    Received: 23 Jun 2024; Accepted: 19 Nov 2024.

    Copyright: © 2024 Sun, Wang, Wang, Wu, Xu and Niu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Dongsheng Niu, Department of Emergency Medicine ,Jincheng People's Hospital, Jincheng, China, Jincheng, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.