Krause R, Klamroth R, Bennhold I, Holick MF, Chen TC, Molzahn M
UVB irradiation reduces cardiac risk in hemodialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract) (Sep) 7:1452 1996

These authors exposed 8 hemodialysis patients to sub-erythematous doses of UV irradiation three times a week for 9 months. They found that vitamin D levels rose (including vitamin D3, 25 hydroxy vitamin D3 and 1,25 dihydroxy vitamin D3) substantially in all patients. In conjunction with the increase in vitamin D, PTH levels and blood pressure fell, while hematocrit rose and lactate levels fell. The authors suggest that these effects were mediated by vitamin D effects on vascular smooth muscle and the parathyroids.

Comment: As these were uncontrolled observations it is difficult to know if they are meaningful. The baseline 1,25 D levels were high normal before any treatment, an unusual finding in dialysis patients unless they were receiving calcitriol. The modest rise in hematocrit certainly could have resulted from other factors (e.g. iron or epo) and we aren't provided with that information.

It would have been useful to assess lipid values in these patients as well, since the focus appears to be on cardiovascular risk factors.

Clearly, despite many questions, this is a provocative finding. One would hope a carefully controlled study would be conducted to answer the methodologic questions. (Donald Sherrard, M.D., University of Washington)

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Am Soc Nephrol
CRF by organ system : Cardiovascular/Hypertension