Association of CKD-MBD Markers with All-Cause Mortality in Prevalent Hemodialysis Patients: A Cohort Study in Beijing

Abstract

The relationships between all-cause mortality and serum intact parathyroid hormone (iPTH), calcium, and phosphate are fairly diverse in patients on maintenance hemodialysis according to prior studies. This study evaluated the association of chronic kidney disease-mineral and bone disorder (CKD-MBD) markers with all-cause mortality in prevalent hemodialysis patients from 2007 to 2012 in Beijing, China. A cohort, involving 8530 prevalent hemodialysis patients who had undergone a 6–70 months follow-up program (with median as 40 months) was formed. Related data was recorded from the database in 120 hemodialysis centers of Beijing Health Bureau (2007 to 2012). Information regarding baseline demographics, blood CKD-MBD markers and all-cause mortality was retrospectively reviewed. By using multivariate Cox regression model analysis, patients with a low iPTH level at baseline were found to have greater risk of mortality (<75pg/ml, HR = 1.36, 95% confidence interval (CI) 1.16–1.60) than those with a baseline iPTH level within 150–300 pg/ml. Similarly, death risk showed an increase when the baseline serum calcium presented a low level (<2.1mmol/L, HR = 1.54; 95% CI 1.37–1.74). Levels of baseline serum phosphorus were not associated with the risk of death. Similar results appeared through the baseline competing risks regression analysis. Patients with a lower level of serum iPTH or calcium are at a higher risk of all-cause mortality compared with those within the range recommended by Kidney Disease Outcome Quality Initiative (KDOQI) guidelines.

Sixty‐Two‐Year‐Old Male Suffering From Uremic Leontiasis Ossea Caused by Severe Secondary Hyperparathyroidism

“…Hence, CKD‐MBD patients should be educated about their illness, early prevention, multidisciplinary early diagnosis, and treatment plans, thereby improving their quality of life and long‐term survival . We hope this case report will highlight the awareness of nephrologist across the globe apropos such cases and timely therapeutic measures would be taken.…”

Risk factors and antihypertensive medications for mortality in elderly hospitalized hemodialysis patients: a multicenter retrospective study in China

“…Studies have confirmed that hypophosphatemia can increase the all-cause mortality and infectionrelated mortality of hemodialysis patients compared with the range of serum phosphorus recommended by the kidney disease outcomes quality initiative (KDOQI) [16][17][18]. Other studies have found that hypophosphatemiaincreases the mortality of hemodialysis patients over 65 years old [19].…”

Low parathyroid hormone level predicts infection-related mortality in incident dialysis patients: a prospective cohort study

“…The relationship between serum iPTH level and allcause mortality in dialysis patients is still controversial. Most epidemiologic studies have suggested that the association between iPTH and all-cause mortality in dialysis patients is U-shaped [12][13][14][15]. Some other researches indicate that there is no correlation between serum iPTH level and mortality risk [1,4,16].…”