RenalWEB links to an April 2008 editorial in Nephrology Dialysis Transplantation which is in response to a meta study and editorial published in the December 2007 in Annals of Internal Medicine.
This is about Vitamin D. The gist is that this meta study, a survey of all the data (papers going back to 1966) does not demonstrate that vitamin D works. The AIM editorial finishes by saying
Pending new evidence from randomized trials, decision makers, physicians, and payers should consider modifying practice guidelines, prescribing patterns, and reimbursement policies [for vitamin D] to reflect the current state of evidence.
This is a serious recommendation which would impact the provision of dialysis here and around the world. NDT steps up to the challenge though and in a really nice way says "You don't know what the hell you're talking about", or at least that's how I interpreted the editorial response. In blog terms it is a thourough Fisking of the AIM editorial. NDT finishes
we strongly disagree with the latter statement [quoted above]: It is absolutely not advisable to withhold the hormone, vitamin D, from dialysis patients, who are severely depleted of vitamin D. This recommendation is potentially dangerous!
Good for NDT. We need more push back on these headline grabbing over-reaches. Again, this points up the need for dialysis research. Dialysis has numerous unanswered questions. Fundamental unanswered questions. We need dialysis research that is independent of the renal pharmacy industrial complex and we need it soon. And in great quantity.
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