Outcomes Associated with Serum Calcium Level in Men with Non-Dialysis-Dependent Chronic Kidney Disease
TLDR
Clinical trials are warranted to determine whether maintaining normal serum calcium can improve outcomes in patients with NDD CKD, and higher serum calcium is associated with increased long-term mortality, and lower calcium isassociated with increased short-term death in patients in the time-varying models.Abstract:
Background and objectives: Elevated serum calcium has been associated with increased mortality in dialysis patients, but it is unclear whether the same is true in non-dialysis-dependent (NDD) chronic kidney disease (CKD). Outcomes associated with low serum calcium are also not well-characterized. Design, setting, participants, & measurements: We examined associations of baseline, time-varying, and time-averaged serum calcium with all-cause mortality in a historic prospective cohort of 1243 men with moderate and advanced NDD CKD by using Cox models. Results: The association of serum calcium with mortality varied according to the applied statistical models. Higher baseline calcium and time-averaged calcium were associated with higher mortality (multivariable adjusted hazard ratio (95% confidence interval): 1.31 (1.13, 1.53); P Conclusions: Higher serum calcium is associated with increased long-term mortality (as reflected by the baseline and time-averaged models), and lower serum calcium is associated with increased short-term mortality (as reflected by the time-varying models) in patients with NDD CKD. Clinical trials are warranted to determine whether maintaining normal serum calcium can improve outcomes in these patients.read more
Citations
More filters
Journal ArticleDOI
Arterial Calcification in Chronic Kidney Disease: Key Roles for Calcium and Phosphate
TL;DR: A major role is suggested for elevated P in promoting osteogenic/chondrogenic differentiation of VSMC, whereas elevated Ca has a predominant role in promoting VSMC apoptosis and vesicle release.
Journal ArticleDOI
Fibroblast growth factor-23: what we know, what we don't know, and what we need to know
TL;DR: FGF23 has recently emerged as one of the most powerful predictors of adverse outcomes in patients with CKD and ESRD and its physiology and pathophysiology is reviewed, and putative mechanisms of action responsible for its negative effects are described and potential therapeutic strategies to treat these are described.
Journal ArticleDOI
Mechanisms and Clinical Consequences of Vascular Calcification
TL;DR: By understanding better the molecular pathways and genetic circuitry responsible for the pathological mineralization process novel drug targets may be identified and exploited to combat and reduce the detrimental effects of vascular calcification on human health.
Journal ArticleDOI
Association of cumulatively low or high serum calcium levels with mortality in long-term hemodialysis patients.
Jessica E. Miller,Csaba P. Kovesdy,Keith C. Norris,Rajnish Mehrotra,Allen R. Nissenson,Joel D. Kopple,Kamyar Kalantar-Zadeh +6 more
TL;DR: Whereas in hemodialysis patients cumulatively high or low calcium levels are associated with higher death risk, subtle but meaningful interactions with phosphorus, PTH, paricalcitol dose and race exist.
Journal ArticleDOI
Factors associated with quality of life among hemodialysis patients in Malaysia.
TL;DR: To improve the overall quality of life of hemodialysis patients, a multidisciplinary intervention that includes medical, dietetic and psychosocial strategies that address factors associated with mental and physical quality ofLife are warranted to reduce further health complications and to improvequality of life.
References
More filters
Journal ArticleDOI
Bone metabolism and disease in chronic kidney disease
Journal ArticleDOI
Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS)
Francesca Tentori,Margaret J. Blayney,Justin M. Albert,Brenda W. Gillespie,Peter G. Kerr,Jürgen Bommer,Eric W. Young,Tadao Akizawa,Takashi Akiba,Ronald L. Pisoni,Bruce M. Robinson,Friedrich K. Port +11 more
TL;DR: The results provide important information about mineral metabolism trends in hemodialysis patients in 12 countries during a decade and may be relevant to efforts at international harmonization of existing clinical guidelines for mineral metabolism.
Journal ArticleDOI
Survival predictability of time-varying indicators of bone disease in maintenance hemodialysis patients
Kamyar Kalantar-Zadeh,Kamyar Kalantar-Zadeh,N. Kuwae,Deborah L. Regidor,Deborah L. Regidor,Csaba P. Kovesdy,Ryan D. Kilpatrick,Ryan D. Kilpatrick,Christian S. Shinaberger,Christian S. Shinaberger,Charles J. McAllister,Matthew J. Budoff,Isidro B. Salusky,Isidro B. Salusky,Joel D. Kopple,Joel D. Kopple +15 more
TL;DR: Associations between high serum parathyroid hormone and increased death risk were masked by case-mix characteristics of MHD patients, and Administration of any dose of paricalcitol was associated with improved survival in time-varying models.
Journal ArticleDOI
Effects of sevelamer and calcium on coronary artery calcification in patients new to hemodialysis
Geoffrey A. Block,David Spiegel,James Ehrlich,Ravindra L. Mehta,Jill Lindbergh,Albert W. Dreisbach,Paolo Raggi +6 more
TL;DR: New hemodialysis patients with no evidence of coronary calcification showed little evidence of disease development over 18 months independent of phosphate binder therapy, however, subjects with evidence of at least mild coronary calcify had significant progression at 6, 12, and 18 months.
Journal ArticleDOI
Predictors and consequences of altered mineral metabolism: The Dialysis Outcomes and Practice Patterns Study
Eric W. Young,Justin M. Albert,Sudtida Satayathum,David A. Goodkin,Ronald L. Pisoni,Takashi Akiba,Tadao Akizawa,Kiyoshi Kurokawa,Jürgen Bommer,Luis Piera,Friedrich K. Port +10 more
TL;DR: This study expands the understanding of the relationship between altered mineral metabolism and outcomes and identifies several potential opportunities for improved practice in this area.
Related Papers (5)
Survival predictability of time-varying indicators of bone disease in maintenance hemodialysis patients
Kamyar Kalantar-Zadeh,Kamyar Kalantar-Zadeh,N. Kuwae,Deborah L. Regidor,Deborah L. Regidor,Csaba P. Kovesdy,Ryan D. Kilpatrick,Ryan D. Kilpatrick,Christian S. Shinaberger,Christian S. Shinaberger,Charles J. McAllister,Matthew J. Budoff,Isidro B. Salusky,Isidro B. Salusky,Joel D. Kopple,Joel D. Kopple +15 more