title: Association of CKD-MBD Markers with All-Cause Mortality in Prevalent Hemodialysis Patients: A Cohort Study in Beijing.
abstract: The relationships between all-cause mortality and serum intact parathyroid hormone (iPTH), calcium, and phosphate are fairly diverse in patients on maintenance hemodialysis according to prior studies. This study evaluated the association of chronic kidney disease-mineral and bone disorder (CKD-MBD) markers with all-cause mortality in prevalent hemodialysis patients from 2007 to 2012 in Beijing, China. A cohort, involving 8530 prevalent hemodialysis patients who had undergone a 6-70 months follow-up program (with median as 40 months) was formed. Related data was recorded from the database in 120 hemodialysis centers of Beijing Health Bureau (2007 to 2012). Information regarding baseline demographics, blood CKD-MBD markers and all-cause mortality was retrospectively reviewed. By using multivariate Cox regression model analysis, patients with a low iPTH level at baseline were found to have greater risk of mortality (<75pg/ml, HR = 1.36, 95% confidence interval (CI) 1.16-1.60) than those with a baseline iPTH level within 150-300 pg/ml. Similarly, death risk showed an increase when the baseline serum calcium presented a low level (<2.1mmol/L, HR = 1.54; 95% CI 1.37-1.74). Levels of baseline serum phosphorus were not associated with the risk of death. Similar results appeared through the baseline competing risks regression analysis. Patients with a lower level of serum iPTH or calcium are at a higher risk of all-cause mortality compared with those within the range recommended by Kidney Disease Outcome Quality Initiative (KDOQI) guidelines.
authors.affiliation: Department of Nephrology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Duo
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Nephrology, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, People's hospital, Peking University, Beijing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zuo
authors.affiliation: School of Social Development and Public Policy, Beijing Normal University.
authors.forename: Cheng Gang
authors.initials: CG
authors.lastname: Jin
authors.affiliation: Department of Nephrology, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Wen Ge
authors.initials: WG
authors.lastname: Li
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Jin-Bor
authors.initials: JB
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000068476:Beijing / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D016016:Proportional Hazards Models; D011787:Quality of Health Care; D012044:Regression Analysis; D006435:Renal Dialysis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D010758:Phosphorus; D002118:Calcium