Association between Extreme Values of Markers of Chronic Kidney Disease: Mineral and Bone Disorder and 5-Year Mortality among Prevalent Hemodialysis Patients.

Authors:
Jin-Bor Chen
Jin-Bor Chen
Chang Gung University College of Medicine
Taiwan
Chih-Hsiung Lee
Chih-Hsiung Lee
Chang Gung University College of Medicine
Taiwan
Gang Long
Gang Long
Wuhan Institute of Virology
China

Blood Purif 2018 22;45(1-3):1-7. Epub 2017 Nov 22.

Department of Nephrology, Tianjin Union Medicine Center, Tianjin, PR China.

Background/aims: We examined the association between markers of chronic kidney disease - mineral and bone disorder (CKD-MBD) and mortality in hemodialysis (HD) patients.

Methods: We retrospectively reviewed the association between markers of CKD-MBD and mortality in 1,126 HD patients from 2009 to 2013 with baseline (B), time-average (TA), and time-dependent (TD) Cox regression models.

Results: Hypercalcemia (10.9-11.9 mg/dL) indicated an increased risk of all-cause mortality (TA: hazard ratio [HR] 3.49; p = 0.01). Hypophosphatemia (2.0-2.5 mg/dL) was significantly associated with an increased risk of all-cause mortality (TA: HR 5.18; p = 0.01). Hypophosphatemia (<2.0 mg/dL) was significantly associated with an increased risk of cardiovascular mortality in all models. Intact parathyroid hormone levels <60 and >1,500 pg/mL indicated an increased risk of all-cause mortality (TA: HR 1.64; p = 0.02; TD: HR 2.26; p = 0.02).

Conclusion: Extreme values of CKD-MBD markers are associated with mortality risk in HD patients. Video Journal Club 'Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=478972.

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http://dx.doi.org/10.1159/000478972DOI Listing
November 2017
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