Hidden Hypocalcemia as a Risk Factor for Cardiovascular Events and All-Cause Mortality among Patients Undergoing Incident Hemodialysis.

摘要: Lower corrected calcium (cCa) levels are associated with a better prognosis among incident dialysis patients. However, cCa frequently overestimates ionized (iCa) levels. The prognostic importance of the true status defined by iCa remains to be revealed. We conducted retrospective cohort study hemodialysis collected data immediately before first dialysis. divided patients into three categories: apparent hypocalcemia (low iCa; <1.15 mmol/L and low cCa; <8.4 mg/dL), hidden despite normal or high cCa), normocalcemia (normal iCa). primary outcome was composite all-cause death cardiovascular diseases after hospital discharge. Among enrolled 332 patients, 75% showed hypocalcemia, as <1.15 mmol/L, 61% whom hypocalcemia. In multivariate Cox models including other potential risk factors, significant factor (hazard ratio [HR], 2.34; 95% confidence interval [CI], 1.03–5.34), whereas <8.4 mg/dL not. Furthermore, significantly an increased compared (HR, 2.56; CI, 1.11–5.94), while Patients were less likely receive interventions correct such doses active vitamin D administration carbonate, than (odds ratio, 0.45; 0.23–0.89). Hidden strong predictor events, suggesting measuring iCa.