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Author Interview: Jose M. Valdivielso, PhD
Experimental Nephrology Laboratory, IRBLLEIDA, Edificio Biomedicina 1, Laboratorio B1–10, Rovira Roure 80, 25198 Lleida, Spain


Assessment of the Potential Role of Active Vitamin D Treatment in Telomere Length: A Case-Control Study in Hemodialysis Patients.

Borras M, Panizo S, Sarró F, Valdivielso JM, Fernandez E.
Nephrology Department, Hospital Universitario Arnau de Vilanova, Lleida, Spain.
Clin Ther. 2012 Mar 12. [Epub ahead of print]

What are the main findings of the study?

The main finding is that hemodialysis (HD) treatment is associated with a decrease in telomere lengthin peripheral mononuclear blood cells (PMBC). Telomeres are special chromatin sequences at the end of chromosomes. These sequences are shortened with age and stress and determine the fate of the cells. When telomere length is too short cells stop dividing and become senescent.

In HD patients, PMBC undergo premature senescence. This finding could be associated with the higher mortality rate observed in HD patients compared with healthy matched controls. Furthermore, active vitamin D treatment has been associated with better survival in HD patients.

In our study, a second important finding is that patients with active vitamin D treatment show higher telomere length that untreated patients, and could be related with the survival advantage observed in clinical practice.

Were any of the findings unexpected?

The finding that active vitamin D is increasing telomere length was somewhat unexpected. The data about the effect of active vitamin D and telomere length are conflictive, and seem to be dependent of the cell type. 

What should clinicians and patients take away from this study?

The main conclusion is that hemodialysis produces a premature aging of the patient, and that strategies aimed to improve the HD process need to be implemented. Further studies should determine whether different HD treatments (frequent, extended, daily HD, etc) show a better profile in PBMC length. It would also be of interest to check whether different membranes show a different effect in telomere length.
Furthermore, the fact that active vitamin D treatment improves telomere length in those patients adds new evidence supporting the use of these compounds in the routine care of HD patients.

What recommendations do you have for future studies as a result of your study?

The main recommendation is to use active vitamin D compounds in the routine treatment of HD patients

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