Uncorrected and Albumin-Corrected Calcium, Phosphorus, and Mortality in Patients Undergoing Maintenance Dialysis

摘要: Uncorrected serum calcium concentration is the first mineral metabolism metric planned for use as a quality measure in United States ESRD population. Few studies patients undergoing either peritoneal dialysis (PD) or hemodialysis (HD) have assessed association of uncorrected with clinical outcomes. We obtained data from 129,076 on (PD, 10,066; HD, 119,010) treated DaVita, Inc. facilities between July 1, 2001, and June 30, 2006. After adjustment potential confounders, <8.5 ≥10.2 mg/dl were associated excess mortality PD HD (comparison group 9.0 to <9.5 mg/dl). Additional albumin substantially attenuated all-cause hazard ratios (HRs) (HR, 1.29; 95% confidence interval [95% CI], 1.16 1.44 PD; HR, 1.17; CI, 1.13 1.20 HD) amplified HRs 1.65; 1.42 1.91 1.59; 1.53 1.65 HD). Albumin-corrected phosphorus ≥6.4 also increased risk death, irrespective modality. In summary, large nationally representative cohort dialysis, abnormalities markers metabolism, particularly high concentrations phosphorus, risk. are needed investigate whether control hypercalcemia hyperphosphatemia results improved