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Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort
Mineral and bone disorder biomarkers ‘normal ranges’ are controversial. The aim of the study was to evaluate the association between serum calcium (Ca), phosphate (P), intact parathyroid hormone (iPTH), and 25(OH) vitamin D levels and mortality risk, in a chronic kidney disease (CKD) grade (G) 3b-4...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Taylor & Francis
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9373789/ https://www.ncbi.nlm.nih.gov/pubmed/35946486 http://dx.doi.org/10.1080/0886022X.2022.2107543 |
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author | Rios, Pablo Silvariño, Ricardo Sola, Laura Ferreiro, Alejandro Lamadrid, Verónica Fajardo, Laura Gadola, Liliana |
author_facet | Rios, Pablo Silvariño, Ricardo Sola, Laura Ferreiro, Alejandro Lamadrid, Verónica Fajardo, Laura Gadola, Liliana |
author_sort | Rios, Pablo |
collection | PubMed |
description | Mineral and bone disorder biomarkers ‘normal ranges’ are controversial. The aim of the study was to evaluate the association between serum calcium (Ca), phosphate (P), intact parathyroid hormone (iPTH), and 25(OH) vitamin D levels and mortality risk, in a chronic kidney disease (CKD) grade (G) 3b-4 cohort. The Uruguayan National Renal Healthcare Program (NRHP-UY) CKD patients’ cohort, included between 1 October 2004 and 1 March 2020 and followed-up until 1 March 2021, was analyzed with the Ethics Committee approval. A total of 6473 patients were analyzed: 56% men, median age 73 (65–79) years, 55% on CKD G3b. At the end of the follow-up, 2459 (37.7%) patients had died (6.4/100 patient–year). There were iPTH data on 2013 patients (younger, with lower estimated glomerular filtration rate (eGFR) and lesser comorbidities). By bivariate Cox analysis the lowest death risk was observed with mean Ca between 9.01 and 10.25 mg/dl, P between 2.76 and 4.0 mg/dl, iPTH ≤ 105 pg/ml, and 25(OH) vitamin D >10 ng/ml. The multivariate Cox regression mortality risk adjusted to age, sex, CKD etiology, diabetes, smoking, cardiovascular comorbidity, blood pressure, proteinuria, eGFR, renin-angiotensin system blockers and vitamin D treatments, serum Ca, P, iPTH, and 25(OH) vitamin D (n = 964) showed that a higher mortality risk was associated with p > 4.00 mg/dl (HR 1.668, CI 95%: 1.201–2.317), iPTH >105 pg/ml (HR 1.386, CI 95%: 1.012–1.989), and 25(OH) vitamin D ≤ 10 ng/ml (HR 1.958, CI 95%: 1.238–3.098) and a lower mortality risk with 1,25(OH)(2) vitamin D treatment (HR 0.639, CI 95%: 0.451–0.906). These data may contribute to the precise G3b-4 CKD-MBD biomarkers levels definition. |
format | Online Article Text |
id | pubmed-9373789 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-93737892022-08-13 Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort Rios, Pablo Silvariño, Ricardo Sola, Laura Ferreiro, Alejandro Lamadrid, Verónica Fajardo, Laura Gadola, Liliana Ren Fail Clinical Study Mineral and bone disorder biomarkers ‘normal ranges’ are controversial. The aim of the study was to evaluate the association between serum calcium (Ca), phosphate (P), intact parathyroid hormone (iPTH), and 25(OH) vitamin D levels and mortality risk, in a chronic kidney disease (CKD) grade (G) 3b-4 cohort. The Uruguayan National Renal Healthcare Program (NRHP-UY) CKD patients’ cohort, included between 1 October 2004 and 1 March 2020 and followed-up until 1 March 2021, was analyzed with the Ethics Committee approval. A total of 6473 patients were analyzed: 56% men, median age 73 (65–79) years, 55% on CKD G3b. At the end of the follow-up, 2459 (37.7%) patients had died (6.4/100 patient–year). There were iPTH data on 2013 patients (younger, with lower estimated glomerular filtration rate (eGFR) and lesser comorbidities). By bivariate Cox analysis the lowest death risk was observed with mean Ca between 9.01 and 10.25 mg/dl, P between 2.76 and 4.0 mg/dl, iPTH ≤ 105 pg/ml, and 25(OH) vitamin D >10 ng/ml. The multivariate Cox regression mortality risk adjusted to age, sex, CKD etiology, diabetes, smoking, cardiovascular comorbidity, blood pressure, proteinuria, eGFR, renin-angiotensin system blockers and vitamin D treatments, serum Ca, P, iPTH, and 25(OH) vitamin D (n = 964) showed that a higher mortality risk was associated with p > 4.00 mg/dl (HR 1.668, CI 95%: 1.201–2.317), iPTH >105 pg/ml (HR 1.386, CI 95%: 1.012–1.989), and 25(OH) vitamin D ≤ 10 ng/ml (HR 1.958, CI 95%: 1.238–3.098) and a lower mortality risk with 1,25(OH)(2) vitamin D treatment (HR 0.639, CI 95%: 0.451–0.906). These data may contribute to the precise G3b-4 CKD-MBD biomarkers levels definition. Taylor & Francis 2022-08-10 /pmc/articles/PMC9373789/ /pubmed/35946486 http://dx.doi.org/10.1080/0886022X.2022.2107543 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Rios, Pablo Silvariño, Ricardo Sola, Laura Ferreiro, Alejandro Lamadrid, Verónica Fajardo, Laura Gadola, Liliana Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort |
title | Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort |
title_full | Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort |
title_fullStr | Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort |
title_full_unstemmed | Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort |
title_short | Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort |
title_sort | mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9373789/ https://www.ncbi.nlm.nih.gov/pubmed/35946486 http://dx.doi.org/10.1080/0886022X.2022.2107543 |
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