Association of CKD-MBD Markers with All-Cause Mortality in Prevalent Hemodialysis Patients: A Cohort Study in Beijing

Li, Duo; Zhang, Ling; Zuo, Li; Jin, Cheng; Li, Wen Ge; Chen, Jin‐Bor

doi:10.1371/journal.pone.0168537

Cited by 18 publications

(15 citation statements)

References 20 publications

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“…Hence, CKD‐MBD patients should be educated about their illness, early prevention, multidisciplinary early diagnosis, and treatment plans, thereby improving their quality of life and long‐term survival . We hope this case report will highlight the awareness of nephrologist across the globe apropos such cases and timely therapeutic measures would be taken.…”

Section: Discussionmentioning

confidence: 90%

Sixty‐Two‐Year‐Old Male Suffering From Uremic Leontiasis Ossea Caused by Severe Secondary Hyperparathyroidism

et al. 2018

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Secondary hyperparathyroidism (SHPT) is a long‐term complication of chronic kidney disease–mineral and bone disorder (CKD‐MBD). SHPT is characterized by hyperplasia of the parathyroid glands and abnormal secretion of parathyroid hormones (PTH), calcium and phosphorous metabolic disorders, renal osteodystrophy, vascular and soft tissue calcification, malnutrition, and other multiple system complications, which can seriously affect the quality of life of the patient and increase the risk of cardiovascular disease and mortality rate. Uremic leontiasis ossea (ULO) is a medical condition only rarely encountered clinically. SHPT causes craniofacial bone deformity accompanied by lesions of the nerve, cardiovascular, respiratory, bone, or other systems within the body. The case discussed here is related to severe SHPT. A 62‐year‐old male patient was suffering from leontiasis ossea, pectus excavatum, vascular calcification, spontaneous bone fractures, and lower limb deformities. He was undergoing hemodialysis and given total parathyroidectomy (TPTX) with autotransplantation (AT). We further analyzed the multivariate therapeutic effects of TPTX on this patient in order to provide clinical data for standardized treatment of individuals with CKD‐MBD. © 2018 The Authors JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

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Section: Discussionmentioning

confidence: 90%

Sixty‐Two‐Year‐Old Male Suffering From Uremic Leontiasis Ossea Caused by Severe Secondary Hyperparathyroidism

et al. 2018

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“…Studies have confirmed that hypophosphatemia can increase the all-cause mortality and infectionrelated mortality of hemodialysis patients compared with the range of serum phosphorus recommended by the kidney disease outcomes quality initiative (KDOQI) [16][17][18]. Other studies have found that hypophosphatemiaincreases the mortality of hemodialysis patients over 65 years old [19].…”

Section: Discussionmentioning

confidence: 90%

Risk factors and antihypertensive medications for mortality in elderly hospitalized hemodialysis patients: a multicenter retrospective study in China

Song¹,

Cai²,

Xiao³

et al. 2019

Preprint

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Background Elderly Hemodialysis patients are increasing yearly. Antihypertensive medications are commonly prescribed to hemodialysis patients but the optimal regimens to prevent morbidity andmortality are unknown. The goal of our study was to compare the association of routinely prescribed antihypertensive regimens with outcomes and analyze the risk factors in elderly hemodialysis patients.Methods This study was a retrospective cohort study based on data from adult hemodialysis patients (≥18 years old) admitted to 15 hospitals in China between 1 January 2009 and 31 December 2011. The characteristics of elderly hemodialysis patients (≥60 years old) were analyzed. Antihypertensive drugs into the following regimens: β-blockers, calcium channel blockers, renin–angiotensin system (RAS) blocking drugs and α-blockers. Logistic regression analysis was used to explore the risk factors for death adjusting for clinical and laboratory values and antihypertensive medications.Results A total of 7135 patients on maintenance hemodialysis including 2738 elderly patients were enrolled in this study. The mean levels of hemoglobin, albumin, blood calcium, phosphorus and parathyroid hormone (PTH) in elderly group were lower than the younger group. We compared the characteristics of 2492 survived elderly maintenance hemodialysis patients and 246 patients who died.Aging (OR = 1.59, 95% CI: 1.13-2.24), central venous catheter (OR = 1.62, 95% CI: 1.53-1.72) and Charlson comorbidities index>3(OR=1.97,95% CI: 1.49-2.60)were independently risk factors of mortality in elderly maintenance hemodialysis patients. High levels of hemoglobin (OR=0.76, 95%CI: 0.73-0.79), albumin (OR=0.87, 95%CI: 0.77-0.98), uric acid(OR=0.90,95%CI: 0.84-0.96)and those taking angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor blocker (ARB) (OR=0.77, 95%CI: 0.58-0.90) had a lower risk of mortality.Conclusions Age, Charlson Comorbidities index >3, anemia and malnutrition, the use of central venous catheters and low serum uric acid level are risk factors for mortality in elderly maintenance hemodialysis patients. Taking ACEI/ARB can reduce the mortality of elderly maintenance hemodialysis patients.

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“…The relationship between serum iPTH level and allcause mortality in dialysis patients is still controversial. Most epidemiologic studies have suggested that the association between iPTH and all-cause mortality in dialysis patients is U-shaped [12][13][14][15]. Some other researches indicate that there is no correlation between serum iPTH level and mortality risk [1,4,16].…”

Section: Discussionmentioning

confidence: 99%

Low parathyroid hormone level predicts infection-related mortality in incident dialysis patients: a prospective cohort study

Hong

Kim

et al. 2020

Korean J Intern Med

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Background/Aims: Parathyroid hormone (PTH) is an important factor influencing immunologic dysfunction, but the effect of PTH level on infection-related outcomes remains unclear in incident dialysis. Methods: We evaluated a multicenter prospective cohort study of 1,771 incident dialysis patients (1,260 hemodialysis and 511 peritoneal dialysis) in Korea. Patients were divided into three groups based on serum intact PTH (iPTH) level. The primary outcomes were all-cause and infection-related mortality and multivariate Cox regression analysis was performed to evaluate the role of iPTH in all-cause and infection-related mortality. Results: During the follow-up period of 27.3 months, 175 patients (9.9%) died, and infection-related death represented 20% of all-cause mortality. Both all-cause mortality and infection-related mortality rates (p < 0.001 and p = 0.003, by logrank) were markedly higher in patients with serum iPTH < 150 pg/mL than in the other groups. Multivariate Cox regression analysis revealed that patients with serum iPTH < 150 pg/mL remained at higher risk for infection-related mortality than patients in the target range of 150 ≤ iPTH < 300 pg/mL, after adjusting for confounding variables (hazard ratio [HR], 2.52; 95% confidence interval, 1.06 to 5.99; p = 0.04). The HR of infection-related mortality in patients with serum iPTH < 150 pg/mL was significantly higher in patients with low serum phosphorus, low Ca × P product, low serum alkaline phosphatase and those older than 65 years. Conclusions: Low serum iPTH level is an independent predictor of infection-related mortality in incident dialysis patients.

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Association of CKD-MBD Markers with All-Cause Mortality in Prevalent Hemodialysis Patients: A Cohort Study in Beijing

Cited by 18 publications

References 20 publications

Sixty‐Two‐Year‐Old Male Suffering From Uremic Leontiasis Ossea Caused by Severe Secondary Hyperparathyroidism

Sixty‐Two‐Year‐Old Male Suffering From Uremic Leontiasis Ossea Caused by Severe Secondary Hyperparathyroidism

Risk factors and antihypertensive medications for mortality in elderly hospitalized hemodialysis patients: a multicenter retrospective study in China

Low parathyroid hormone level predicts infection-related mortality in incident dialysis patients: a prospective cohort study

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