title: Effects of serum calcium, phosphorous, and intact parathyroid hormone levels on survival in chronic hemodialysis patients in Japan.
abstract: Disturbances in bone mineral metabolism are common in chronic hemodialysis (HD) patients and often underlie morbid conditions and mortality; however, no large epidemiological study for Asian dialysis patients has been performed. We analyzed the database of the Japanese Society for Dialysis Therapy registry. In this study, data from patients who were on HD at the end of 2000 was compiled. The Cox's proportional hazard analysis was carried out to evaluate the significance of the impact of variables related to bone mineral metabolism on survival after adjusting for possible confounding variables. The study period was three years, and a cohort of 27 404 HD patients was studied. The hazard ratios were 1.098 (P = 0.0129) for serum calcium levels ranging 10.0-10.9 mg/dL, and 1.243 (P = 0.0001) for serum calcium levels >11.0 mg/dL when the reference serum calcium level range was 9.0-9.9 mg/dL. Similarly, the hazard ratios were significantly higher in a serum phosphorous level of 5.0 mg/dL than for the reference serum phosphorous level range of 4.0-4.9 mg/dL. For intact parathyroid hormone (iPTH), the hazard ratios were significantly small (<119 pg/mL) when the reference iPTH level range was 180-359 pg/mL. However, the hazard ratio did not increase when the iPTH level increased to >360 pg/mL. Results showed that disturbances in bone mineral metabolism, such as those involving serum calcium, phosphorous, and iPTH, have a significant impact on survival in Japanese dialysis patients.
authors.affiliation: Fujita Health University School of Medicine, Dengakugakubo 1-98, Kutsukake, Toyoake, Aichi 470-1192, Japan. s-nakai@mta.biglobe.ne.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nakai
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiba
authors.forename: Junichiro
authors.initials: J
authors.lastname: Kazama
authors.forename: Keitaro
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukagawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tominaga
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Tsubakihara
mesh_terms: D000368:Aged; D044466:Asian People; D001851:Bone Diseases, Metabolic / Q000209:etiology*; D002118:Calcium / Q000097:blood*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010758:Phosphorus / Q000097:blood*; D016016:Proportional Hazards Models; D012042:Registries; D006435:Renal Dialysis; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D010281:Parathyroid Hormone; D010758:Phosphorus; D002118:Calcium