Serum iPTH, calcium and phosphate, and the risk of mortality in a European haemodialysis population

摘要: Background. A number of US observational studies reported an increased mortality risk with higher intact parathyroid hormone (iPTH), calcium and/or phosphate. The existence such a link in European haemodialysis population was explored as part the Analysing Data, Recognising Excellence and Optimising Outcomes (ARO) Chronic Kidney Disease (CKD) Research Initiative. Methods. association between markers mineral bone disease clinical outcomes examined 7970 patients treated Fresenius Medical Care facilities over median 21 months. Baseline time-dependent (TD) Cox regression were performed using Quality Initiative (KDOQI) target ranges reference categories, adjusting for demographics, medical history, dialysis parameters, inflammation, medications laboratory parameters. Fractional polynomial (FP) models also used. Results. Hazard ratio (HR) estimates from baseline analysis iPTH U-shaped [>600 pg/mL, HR = 2.10, 95% confidence interval (CI) 1.62–2.73; 2.75 mmol/L death (HR 1.70, CI 1.19–2.42). TD showed that both low 1.19, 1.04–1.37) high 1.74, 1.30–2.34) death. phosphate pattern ( 1.78 mmol/L, 1.32, 1.13–1.55). confirmed results <1.13 mmol/L. diabetes versus those without only (P-value 0.014). FP analyses. Conclusion. Patients iPTH, levels within KDOQI have lowest compared outside ranges.