Changes in 3-month mineral and bone disorder patterns were associated with all-cause mortality in prevalent hemodialysis
- PDF / 966,472 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 35 Downloads / 135 Views
RESEARCH ARTICLE
Open Access
Changes in 3-month mineral and bone disorder patterns were associated with allcause mortality in prevalent hemodialysis patients with secondary hyperparathyroidism Chihiro Kato1†, Naohiko Fujii2†, Chisato Miyakoshi3,4,5, Shinji Asada1* , Yoshihiro Onishi5, Shingo Fukuma5,6,7, Takanobu Nomura1, Michihito Wada1, Masafumi Fukagawa8, Shunichi Fukuhara3 and Tadao Akizawa9
Abstract Background: There is limited evidence on the association between short-term changes in mineral and bone disorder parameters and survival in maintenance hemodialysis patients. Methods: We investigated the association between changing patterns of phosphorus, calcium and intact parathyroid hormone levels and all-cause mortality in hemodialysis patients with secondary hyperparathyroidism. Each parameter was divided into three categories (low [L], middle [M] and high [H]), and the changing patterns between two consecutive visits at 3-month intervals were categorized into nine groups (e.g., L-L and M-H). The middle category was defined as 4.0–7.0 mg/dL for phosphorous, 8.5–9.5 mg/dL for calcium and 200–500 pg/mL for intact parathyroid hormone. Adjusted incidence rates and rate ratios were analyzed by weighted Poisson regression models accounting for time-dependent exposures. Results: For phosphorus, shifts from low/high to middle category (L-M/H-M) were associated with a lower mortality compared with the L-L and H–H groups, whereas shifts from middle to low/high category (M-L/M-H) were associated with a higher mortality compared with the M-M group. For calcium, shifts from low/middle to high category (L–H/M-H) were associated with a higher mortality compared with the L-L and M-M groups, whereas shifts from high to middle category (H-M) were associated with a lower mortality compared with the H–H group. For intact parathyroid hormone, shifts from low to middle category (L-M) were associated with a lower mortality compared with the L-L group. Conclusions: Changes in the 3-month patterns of phosphorus and calcium toward the middle category were associated with lower mortality. Our study also suggests the importance of avoiding hypercalcemia. Keywords: Changing pattern, CKD-MBD, Hemodialysis, Secondary hyperparathyroidism, Mortality
* Correspondence: [email protected] † Chihiro Kato and Naohiko Fujii contributed equally to this work. 1 Medical Affairs Department, Kyowa Kirin Co., Ltd, Otemachi Financial City Grand Cube, 1-9-2 Otemachi, Chiyoda-ku, Tokyo 100-0004, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative
Data Loading...
