title: [Serum calcium levels at first renal replacement therapy and patients survival].
abstract: In K/DOQI guideline, albumin adjusted serum calcium concentrations between 8.4 to 9.5 mg/dL and serum phosphorus concentrations between 3.5 to 5.5 mg/dL are recommended. But without clinical symptoms relating to hypocalcemia, medication for increasing serum calcium levels is not needed even less than 8.4 mg/dL. To clarify this guideline, we examined the data of 271 patients who started dialysis at Shinrakuen Hospital, their medication before renal replacement therapy and life prognosis. Medication made higher serum calcium concentrations (p< 0.005) at first renal replacement therapy. Concerning serum calcium concentrations, the lower group (<8.4 mg/dL) showed significantly better prognosis than the middle group (8.4 to 9.5 mg/dL) and the higher group (>9.5 mg/dL) (p< 0.05). When serum calcium levels were adjusted for the level of serum albumin, this tendency was stronger (p< 0.0001). We concluded that although serum calcium concentrations might not need control, nutritional states are far more important before starting dialysis.
authors.affiliation: Kidney Center of Shinrakuen Hospital.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Osawa
authors.forename: Ikuo
authors.initials: I
authors.lastname: Aoike
authors.forename: Tai
authors.initials: T
authors.lastname: Sakurabayashi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Yuasa
authors.forename: Masashi
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000008:administration & dosage / Q000097:blood*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D009752:Nutritional Status; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D017582:Renal Replacement Therapy / Q000009:adverse effects; D012709:Serum Albumin / Q000378:metabolism; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D012709:Serum Albumin; D014807:Vitamin D; D010758:Phosphorus; D002118:Calcium