Intensive care unit patients with sepsis-associated acute kidney injury who received vitamin D supplementation had a 41% lower risk of in-hospital mortality compared to those who did not, according to a retrospective study published in Frontiers in Medicine.

The study analyzed 11,896 intensive care unit (ICU) patients from Beth Israel Deaconess Medical Center's MIMIC-IV database (2008-2019), with 2,724 receiving vitamin D supplementation during their stay. Using propensity score matching and multiple statistical models, the researchers found consistent reductions in mortality risk (hazard ratio [HR], 0.56; 95% CI, 0.50-0.63; P < .001). Kaplan-Meier survival curves showed significantly higher survival rates in the vitamin D group compared to the no-vitamin D group. E-value analysis (2.78-3.18) indicated robustness against potential unmeasured confounders.

Secondary outcomes supported the primary findings. Mortality rates at 28 and 90 days were significantly lower in the vitamin D group (16.5% vs 26.3% and 23.3% vs 34.7%, respectively; both P < .001). Patients receiving vitamin D had more norepinephrine-free days (21.7 ± 10.5 vs 19.6 ± 11.9 days; P < .001).

Baseline imbalances, including higher comorbidity scores in the vitamin D group, were addressed through propensity score matching. Subgroup and sensitivity analyses confirmed the stability of the results across variables such as age, mechanical ventilation, and severity of illness.

The researchers noted this was the first study to examine vitamin D supplementation specifically in ICU patients with sepsis-associated acute kidney injury (SA-AKI). Limitations included its retrospective design, lack of vitamin D level assessments, potential residual confounding despite statistical adjustments, and absence of dosing strategy exploration. The authors suggest that prospective clinical trials are needed to provide definitive evidence and establish optimal supplementation protocols.

Full disclosures can be found in the published study.