Association of Pre-ESRD Serum Calcium With Post-ESRD Mortality Among Incident ESRD Patients: A Cohort Study.

摘要: Albumin-corrected serum calcium (cSCa) decline at late stages of chronic kidney disease and rise after dialysis initiation. Although hypercalcemia is associated with higher mortality in end-stage renal (ESRD), there are scarce data on the impact pre-ESRD cSCa post-ESRD mortality. Therefore, we used a large national cohort 21,826 US veterans who transitioned to all Department Veterans Affairs health care facilities over 2009 2014 examine associations all-cause cause-specific (1) concentrations averaged last 6 months (2) its rate during 12 before Mean median were 9.3 ± 0.7 mg/dL -0.15 (interquartile range -0.39 0.07) mg/dL/year, respectively. A total 9596 patients died follow-up period (mean 1.9 years; 41,541 patient-years) an incidence 23.1 per 100 patient-years. There was independent linear association between (ptrend < 0.001). The risk ≥9.0 mg/dL attenuated among active vitamin D users (pinteraction Patients faster showed lower irrespective baseline concentrations. These cSCa-mortality stronger for noncardiovascular versus cardiovascular death. In conclusion, consistently linearly better survival veterans, especially Further studies needed determine if correcting hypocalcemia beneficial or harmful which intervention preferred when indicated transitioning ESRD. © 2018 American Society Bone Mineral Research.