title: Higher impact of mineral metabolism on cardiovascular mortality in a European hemodialysis population.
abstract: BACKGROUND
  Cardiovascular disease is the main cause of morbidity and mortality among hemodialysis patients. Chronic renal failure influences a number of factors that cause accelerated atherogenesis, with calcium, phosphorus, and PTH playing key roles. Several studies have demonstrated the influence of these factors on all-cause and cardiovascular mortality in the American hemodialysis population. In the present study we evaluated the variables that influence long-term cardiovascular mortality in a European hemodialysis population.
  
  
  METHODS
  One hundred and forty-three hemodialysis patients were followed for six years. Several Cox models were used to study the influence of demographic and biochemical data, and comorbid conditions in cardiovascular survival, with a particular interest in mineral metabolism.
  
  
  RESULTS
  There was an increased risk of cardiovascular death in patients with serum P>6.5 mg/dL (risk ratio [RR], 2.5), PTH>50 pmol/L (RR, 3.9), Ca x P>52 (RR, 2.8), BB or Bb genotype (RR, 3.8), and in diabetics.
  
  
  CONCLUSIONS
  There is a stronger influence of mineral metabolism on cardiovascular death among European patients when compared to the American population.
authors.affiliation: Nephrology Service, Hospital Universitari Arnau de Vilanova and Department of Medicine, University of Lleida, Spain. mmarco@arnau.scs.es
authors.forename: Maria Paz
authors.initials: MP
authors.lastname: Marco
authors.forename: Lourdes
authors.initials: L
authors.lastname: Craver
authors.forename: Angels
authors.initials: A
authors.lastname: Betriu
authors.forename: Montserrat
authors.initials: M
authors.lastname: Belart
authors.forename: Joan
authors.initials: J
authors.lastname: Fibla
authors.forename: Elvira
authors.initials: E
authors.lastname: Fernández
mesh_terms: D000368:Aged; D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000235:genetics / Q000401:mortality*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007676:Kidney Failure, Chronic / Q000235:genetics / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000378:metabolism*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018167:Receptors, Calcitriol / Q000235:genetics; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008903:Minerals; D018167:Receptors, Calcitriol