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Association of mineral metabolism factors with all-cause and cardiovascular mortality in hemodialysis patients: the Japan dialysis outcomes and practice patterns study.
Hemodial Int. 2007 Jul; 11(3):340-8.HI

Abstract

Abnormalities in mineral metabolism have been linked to mortality in hemodialysis (HD) patients. We postulated that these abnormalities would have a particularly large deleterious impact on deaths due to cardiovascular causes in Japan. This study describes the recent status of abnormal mineral metabolism, significant predictors, and potential consequences in the Dialysis Outcomes and Practice Patterns Study (DOPPS), Phases 1 and 2, in Japan. Major predictor variables were patient demographics, comorbidities, and laboratory markers of mineral metabolism such as albumin-adjusted serum calcium (calciumAlb), phosphorus, and intact PTH (iPTH). In a cross section of 3973 Japanese HD patients in DOPPS I and II, a large faction had laboratory values outside of the recommended Kidney Disease Outcomes Quality Initiative (K/DOQI) guideline range for serum concentrations of phosphorus (51% of patients above upper target range), calciumAlb (43.7% above), calcium-phosphorus (Ca x P) product (41.1% above), and iPTH (18.6% above). All-cause mortality was significantly and independently associated with calciumAlb (relative risk [RR]=1.22 per 1 mg/dL, p=0.0005) and iPTH (RR=1.04 per 100 pg/mL, p=0.04). Cardiovascular mortality was significantly associated with calciumAlb (RR=1.28, p=0.02), phosphorus (RR=1.13 per 1 mg/dL, p=0.008), Ca x P product (RR=1.07 per 2 mg(2)/dL(2), p=0.002), and PTH (RR=1.08, p=0.0001). This study expands our understanding of the relationship between altered mineral metabolism and mortality outcomes, showing slightly stronger associations with cardiovascular causes than observed for all-cause mortality. These findings have important therapeutic implications for Japanese HD patients.

Authors+Show Affiliations

Kidney Center, Division of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17576300

Citation

Kimata, Naoki, et al. "Association of Mineral Metabolism Factors With All-cause and Cardiovascular Mortality in Hemodialysis Patients: the Japan Dialysis Outcomes and Practice Patterns Study." Hemodialysis International. International Symposium On Home Hemodialysis, vol. 11, no. 3, 2007, pp. 340-8.
Kimata N, Albert JM, Akiba T, et al. Association of mineral metabolism factors with all-cause and cardiovascular mortality in hemodialysis patients: the Japan dialysis outcomes and practice patterns study. Hemodial Int. 2007;11(3):340-8.
Kimata, N., Albert, J. M., Akiba, T., Yamazaki, S., Kawaguchi, T., Kawaguchi, Y., Fukuhara, S., Akizawa, T., Saito, A., Asano, Y., Kurokawa, K., Pisoni, R. L., & Port, F. K. (2007). Association of mineral metabolism factors with all-cause and cardiovascular mortality in hemodialysis patients: the Japan dialysis outcomes and practice patterns study. Hemodialysis International. International Symposium On Home Hemodialysis, 11(3), 340-8.
Kimata N, et al. Association of Mineral Metabolism Factors With All-cause and Cardiovascular Mortality in Hemodialysis Patients: the Japan Dialysis Outcomes and Practice Patterns Study. Hemodial Int. 2007;11(3):340-8. PubMed PMID: 17576300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of mineral metabolism factors with all-cause and cardiovascular mortality in hemodialysis patients: the Japan dialysis outcomes and practice patterns study. AU - Kimata,Naoki, AU - Albert,Justin M, AU - Akiba,Takashi, AU - Yamazaki,Shin, AU - Kawaguchi,Takehiko, AU - Kawaguchi,Yoshindo, AU - Fukuhara,Shunichi, AU - Akizawa,Tadao, AU - Saito,Akira, AU - Asano,Yasushi, AU - Kurokawa,Kiyoshi, AU - Pisoni,Ronald L, AU - Port,Friedrich K, PY - 2007/6/20/pubmed PY - 2007/12/28/medline PY - 2007/6/20/entrez SP - 340 EP - 8 JF - Hemodialysis international. International Symposium on Home Hemodialysis JO - Hemodial Int VL - 11 IS - 3 N2 - Abnormalities in mineral metabolism have been linked to mortality in hemodialysis (HD) patients. We postulated that these abnormalities would have a particularly large deleterious impact on deaths due to cardiovascular causes in Japan. This study describes the recent status of abnormal mineral metabolism, significant predictors, and potential consequences in the Dialysis Outcomes and Practice Patterns Study (DOPPS), Phases 1 and 2, in Japan. Major predictor variables were patient demographics, comorbidities, and laboratory markers of mineral metabolism such as albumin-adjusted serum calcium (calciumAlb), phosphorus, and intact PTH (iPTH). In a cross section of 3973 Japanese HD patients in DOPPS I and II, a large faction had laboratory values outside of the recommended Kidney Disease Outcomes Quality Initiative (K/DOQI) guideline range for serum concentrations of phosphorus (51% of patients above upper target range), calciumAlb (43.7% above), calcium-phosphorus (Ca x P) product (41.1% above), and iPTH (18.6% above). All-cause mortality was significantly and independently associated with calciumAlb (relative risk [RR]=1.22 per 1 mg/dL, p=0.0005) and iPTH (RR=1.04 per 100 pg/mL, p=0.04). Cardiovascular mortality was significantly associated with calciumAlb (RR=1.28, p=0.02), phosphorus (RR=1.13 per 1 mg/dL, p=0.008), Ca x P product (RR=1.07 per 2 mg(2)/dL(2), p=0.002), and PTH (RR=1.08, p=0.0001). This study expands our understanding of the relationship between altered mineral metabolism and mortality outcomes, showing slightly stronger associations with cardiovascular causes than observed for all-cause mortality. These findings have important therapeutic implications for Japanese HD patients. SN - 1492-7535 UR - https://www.unboundmedicine.com/medline/citation/17576300/Association_of_mineral_metabolism_factors_with_all_cause_and_cardiovascular_mortality_in_hemodialysis_patients:_the_Japan_dialysis_outcomes_and_practice_patterns_study_ L2 - https://doi.org/10.1111/j.1542-4758.2007.00190.x DB - PRIME DP - Unbound Medicine ER -