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

SIMPLE SUMMARY: This study investigated the effect of vitamin D supplementation on the risk of dementia in patients with end-stage renal disease on hemodialysis, which is a novel contribution to the literature. To our knowledge, this is the first study to examine the relationship between vitamin D supplementation and the risk of dementia in this patient population. The use of a 1:1 propensity score-matched cohort design adds robustness and reliability to the study findings. The results demonstrated that vitamin D supplementation at doses of ≥70 μg/week significantly reduced the risk of dementia in a dose-dependent manner, regardless of age. These findings add new and important information to the existing literature on the relationship between vitamin D and cognitive health in ESRD patients on hemodialysis, and suggest that vitamin D supplementation may be an effective preventive strategy for cognitive impairment in this vulnerable patient population. 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.