Higher impact of mineral metabolism on cardiovascular mortality in a European hemodialysis population.
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.
Marco
Maria Paz
MP
Nephrology Service, Hospital Universitari Arnau de Vilanova and Department of Medicine, University of Lleida, Spain. mmarco@arnau.scs.es
Craver
Lourdes
L
Betriu
Angels
A
Belart
Montserrat
M
Fibla
Joan
J
Fernández
Elvira
E
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
D015415:Biomarkers; D008903:Minerals; D018167:Receptors, Calcitriol