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Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes
BACKGROUND: Numerous studies have evaluated the prevalence and importance of mineral and bone disorders among patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). However, little is known about dysregulated mineral and bone metabolism in acute kidney injury (AKI). METHODS:...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794865/ https://www.ncbi.nlm.nih.gov/pubmed/31615432 http://dx.doi.org/10.1186/s12882-019-1572-y |
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author | Yang, Tianye Wang, Wenji Tang, Xiao Shi, Peng Zhang, Lulu Yu, Wenyan Xie, Yingxin Guo, Daqiao Ding, Feng |
author_facet | Yang, Tianye Wang, Wenji Tang, Xiao Shi, Peng Zhang, Lulu Yu, Wenyan Xie, Yingxin Guo, Daqiao Ding, Feng |
author_sort | Yang, Tianye |
collection | PubMed |
description | BACKGROUND: Numerous studies have evaluated the prevalence and importance of mineral and bone disorders among patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). However, little is known about dysregulated mineral and bone metabolism in acute kidney injury (AKI). METHODS: We evaluated the association between mineral and bone metabolites and clinical outcomes in 158 patients who underwent cardiac surgery and developed AKI between June 2014 and January 2016. The baseline characteristics of the patients were recorded, and the levels of mineral and bone metabolites, including calcium, phosphate, intact parathyroid hormone (iPTH), 25-hydroxyvitamin D (25D), bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRACP-5b) and C-terminal fibroblast growth factor 23 (cFGF23) were measured within 12 h after establishing the clinical diagnosis. RESULTS: The serum phosphate, iPTH and cFGF23 levels were significantly associated with the 28-day mortality (phosphate: Hazard Ratio [HR] =2.620, 95% CI: 1.083 to 6.338, p = 0.035; iPTH: HR = 1.044, 95% CI: 1.001 to 1.090, p = 0.046; cFGF23: HR = 1.367, 95% CI: 1.168 to 1.599, p < 0.001). Moreover, higher serum cFGF23 and BAP levels were independently associated with an increased risk of adverse outcomes. Additionally, we found that the serum cFGF23 levels rose most significantly and were associated with the severity of AKI (P < 0.001). CONCLUSIONS: Mineral and bone metabolites are dysregulated and are associated with adverse clinical outcomes among patients with AKI. TRIAL REGISTRATION: www.clinicaltrials.gov NCT 00953992. Registered 6 August 2009. |
format | Online Article Text |
id | pubmed-6794865 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67948652019-10-21 Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes Yang, Tianye Wang, Wenji Tang, Xiao Shi, Peng Zhang, Lulu Yu, Wenyan Xie, Yingxin Guo, Daqiao Ding, Feng BMC Nephrol Research Article BACKGROUND: Numerous studies have evaluated the prevalence and importance of mineral and bone disorders among patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). However, little is known about dysregulated mineral and bone metabolism in acute kidney injury (AKI). METHODS: We evaluated the association between mineral and bone metabolites and clinical outcomes in 158 patients who underwent cardiac surgery and developed AKI between June 2014 and January 2016. The baseline characteristics of the patients were recorded, and the levels of mineral and bone metabolites, including calcium, phosphate, intact parathyroid hormone (iPTH), 25-hydroxyvitamin D (25D), bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRACP-5b) and C-terminal fibroblast growth factor 23 (cFGF23) were measured within 12 h after establishing the clinical diagnosis. RESULTS: The serum phosphate, iPTH and cFGF23 levels were significantly associated with the 28-day mortality (phosphate: Hazard Ratio [HR] =2.620, 95% CI: 1.083 to 6.338, p = 0.035; iPTH: HR = 1.044, 95% CI: 1.001 to 1.090, p = 0.046; cFGF23: HR = 1.367, 95% CI: 1.168 to 1.599, p < 0.001). Moreover, higher serum cFGF23 and BAP levels were independently associated with an increased risk of adverse outcomes. Additionally, we found that the serum cFGF23 levels rose most significantly and were associated with the severity of AKI (P < 0.001). CONCLUSIONS: Mineral and bone metabolites are dysregulated and are associated with adverse clinical outcomes among patients with AKI. TRIAL REGISTRATION: www.clinicaltrials.gov NCT 00953992. Registered 6 August 2009. BioMed Central 2019-10-15 /pmc/articles/PMC6794865/ /pubmed/31615432 http://dx.doi.org/10.1186/s12882-019-1572-y Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Yang, Tianye Wang, Wenji Tang, Xiao Shi, Peng Zhang, Lulu Yu, Wenyan Xie, Yingxin Guo, Daqiao Ding, Feng Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes |
title | Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes |
title_full | Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes |
title_fullStr | Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes |
title_full_unstemmed | Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes |
title_short | Association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes |
title_sort | association between mineral and bone disorder in patients with acute kidney injury following cardiac surgery and adverse outcomes |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794865/ https://www.ncbi.nlm.nih.gov/pubmed/31615432 http://dx.doi.org/10.1186/s12882-019-1572-y |
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