Mineral metabolism and mortality in dialysis patients: a reassessment of the K/DOQI guideline

Marlies Noordzij; Johanna C. Korevaar; Friedo W. Dekker; Elisabeth W. Boeschoten; Willem J. Bos; Raymond T. Krediet; Patrick M. Bossuyt; Ronald B. Geskus

doi:https://doi.org/10.1159/000118847

Mineral metabolism and mortality in dialysis patients: a reassessment of the K/DOQI guideline

Marlies Noordzij, Johanna C. Korevaar, Friedo W. Dekker, Elisabeth W. Boeschoten, Willem J. Bos, Raymond T. Krediet, Patrick M. Bossuyt, Ronald B. Geskus

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: Several studies found associations between higher plasma calcium and phosphorus and mortality in dialysis patients. However, different predefined categories and reference values were applied and the precise shape of these relationships remains unclear. METHODS: We evaluated 1,621 patients from NECOSAD, a prospective multicenter cohort study of incident dialysis patients (60 +/- 15 years, 61% male, 64% hemodialysis). We used multivariate Cox regression and restricted cubic spline regression to study the effects of time-updated plasma concentrations on mortality in a flexible manner. RESULTS: 486 patients (30%) died during follow-up. Elevated phosphorus concentration was associated with higher mortality (p = 0.0009). The association of high calcium with mortality was borderline significant (p = 0.07). Within the studied ranges, we could not identify a threshold where an appreciable change in mortality risk occurred. CONCLUSIONS: Mortality risk started to increase at a relatively low phosphorus concentration (4.5 mg/dl). Low-normal calcium combined with low-normal phosphorus concentration was associated with the lowest mortality

Original language	English
Pages (from-to)	231-237
Journal	Blood Purification
Volume	26
Issue number	3
DOIs	https://doi.org/10.1159/000118847
Publication status	Published - 2008

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https://doi.org/10.1159/000118847

Cite this

@article{badaba5e487a41948954480bf53db1e1,

title = "Mineral metabolism and mortality in dialysis patients: a reassessment of the K/DOQI guideline",

abstract = "BACKGROUND: Several studies found associations between higher plasma calcium and phosphorus and mortality in dialysis patients. However, different predefined categories and reference values were applied and the precise shape of these relationships remains unclear. METHODS: We evaluated 1,621 patients from NECOSAD, a prospective multicenter cohort study of incident dialysis patients (60 +/- 15 years, 61% male, 64% hemodialysis). We used multivariate Cox regression and restricted cubic spline regression to study the effects of time-updated plasma concentrations on mortality in a flexible manner. RESULTS: 486 patients (30%) died during follow-up. Elevated phosphorus concentration was associated with higher mortality (p = 0.0009). The association of high calcium with mortality was borderline significant (p = 0.07). Within the studied ranges, we could not identify a threshold where an appreciable change in mortality risk occurred. CONCLUSIONS: Mortality risk started to increase at a relatively low phosphorus concentration (4.5 mg/dl). Low-normal calcium combined with low-normal phosphorus concentration was associated with the lowest mortality",

author = "Marlies Noordzij and Korevaar, {Johanna C.} and Dekker, {Friedo W.} and Boeschoten, {Elisabeth W.} and Bos, {Willem J.} and Krediet, {Raymond T.} and Bossuyt, {Patrick M.} and Geskus, {Ronald B.}",

year = "2008",

doi = "https://doi.org/10.1159/000118847",

language = "English",

volume = "26",

pages = "231--237",

journal = "Blood Purification",

issn = "0253-5068",

publisher = "S. Karger AG",

number = "3",

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TY - JOUR

T1 - Mineral metabolism and mortality in dialysis patients: a reassessment of the K/DOQI guideline

AU - Noordzij, Marlies

AU - Korevaar, Johanna C.

AU - Dekker, Friedo W.

AU - Boeschoten, Elisabeth W.

AU - Bos, Willem J.

AU - Krediet, Raymond T.

AU - Bossuyt, Patrick M.

AU - Geskus, Ronald B.

PY - 2008

Y1 - 2008

N2 - BACKGROUND: Several studies found associations between higher plasma calcium and phosphorus and mortality in dialysis patients. However, different predefined categories and reference values were applied and the precise shape of these relationships remains unclear. METHODS: We evaluated 1,621 patients from NECOSAD, a prospective multicenter cohort study of incident dialysis patients (60 +/- 15 years, 61% male, 64% hemodialysis). We used multivariate Cox regression and restricted cubic spline regression to study the effects of time-updated plasma concentrations on mortality in a flexible manner. RESULTS: 486 patients (30%) died during follow-up. Elevated phosphorus concentration was associated with higher mortality (p = 0.0009). The association of high calcium with mortality was borderline significant (p = 0.07). Within the studied ranges, we could not identify a threshold where an appreciable change in mortality risk occurred. CONCLUSIONS: Mortality risk started to increase at a relatively low phosphorus concentration (4.5 mg/dl). Low-normal calcium combined with low-normal phosphorus concentration was associated with the lowest mortality

AB - BACKGROUND: Several studies found associations between higher plasma calcium and phosphorus and mortality in dialysis patients. However, different predefined categories and reference values were applied and the precise shape of these relationships remains unclear. METHODS: We evaluated 1,621 patients from NECOSAD, a prospective multicenter cohort study of incident dialysis patients (60 +/- 15 years, 61% male, 64% hemodialysis). We used multivariate Cox regression and restricted cubic spline regression to study the effects of time-updated plasma concentrations on mortality in a flexible manner. RESULTS: 486 patients (30%) died during follow-up. Elevated phosphorus concentration was associated with higher mortality (p = 0.0009). The association of high calcium with mortality was borderline significant (p = 0.07). Within the studied ranges, we could not identify a threshold where an appreciable change in mortality risk occurred. CONCLUSIONS: Mortality risk started to increase at a relatively low phosphorus concentration (4.5 mg/dl). Low-normal calcium combined with low-normal phosphorus concentration was associated with the lowest mortality

U2 - https://doi.org/10.1159/000118847

DO - https://doi.org/10.1159/000118847

M3 - Article

C2 - 18305386

SN - 0253-5068

VL - 26

SP - 231

EP - 237

JO - Blood Purification

JF - Blood Purification

IS - 3

ER -