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...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Renal Failure |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2107543 |
| _version_ | 1798037706579640320 |
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| author | Pablo Rios Ricardo Silvariño Laura Sola Alejandro Ferreiro Verónica Lamadrid Laura Fajardo Liliana Gadola |
| author_facet | Pablo Rios Ricardo Silvariño Laura Sola Alejandro Ferreiro Verónica Lamadrid Laura Fajardo Liliana Gadola |
| author_sort | Pablo Rios |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-11T21:30:12Z |
| format | Article |
| id | doaj.art-4a223798b259497ba1587d578bb49dfc |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-04-11T21:30:12Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-4a223798b259497ba1587d578bb49dfc2022-12-22T04:02:02ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492022-12-014411356136710.1080/0886022X.2022.2107543Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohortPablo Rios0Ricardo Silvariño1Laura Sola2Alejandro Ferreiro3Verónica Lamadrid4Laura Fajardo5Liliana Gadola6Comisión Asesora Programa de Salud Renal, Fondo Nacional de Recursos, Montevideo, UruguayComisión Asesora Programa de Salud Renal, Fondo Nacional de Recursos, Montevideo, UruguayComisión Asesora Programa de Salud Renal, Fondo Nacional de Recursos, Montevideo, UruguayComisión Asesora Programa de Salud Renal, Fondo Nacional de Recursos, Montevideo, UruguayComisión Asesora Programa de Salud Renal, Fondo Nacional de Recursos, Montevideo, UruguaySociedad Uruguaya de Nefrología, Montevideo, UruguayComisión Asesora Programa de Salud Renal, Fondo Nacional de Recursos, Montevideo, UruguayMineral 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.https://www.tandfonline.com/doi/10.1080/0886022X.2022.2107543Calciumchronic kidney disease 3b-4mineral metabolismparathyroid hormonephosphatesurvival analysis |
| spellingShingle | Pablo Rios Ricardo Silvariño Laura Sola Alejandro Ferreiro Verónica Lamadrid Laura Fajardo Liliana Gadola Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort Renal Failure Calcium chronic kidney disease 3b-4 mineral metabolism parathyroid hormone phosphate survival analysis |
| 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 | Calcium chronic kidney disease 3b-4 mineral metabolism parathyroid hormone phosphate survival analysis |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2022.2107543 |
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