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Alkaline phosphatase and mortality in patients on peritoneal dialysis.
Clin J Am Soc Nephrol. 2014 Apr; 9(4):771-8.CJ

Abstract

BACKGROUND AND OBJECTIVES

Elevated total serum alkaline phosphatase levels have been associated with higher mortality in the general population, CKD patients, and hemodialysis patients. However, in peritoneal dialysis patients, this association has received little attention. The aim of this study was to evaluate the association between alkaline phosphatase and all-cause and cardiovascular mortality in peritoneal dialysis patients.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

In this single center retrospective cohort study, 1021 incident peritoneal dialysis patients from January 1, 2006, to December 31, 2010 with baseline serum alkaline phosphatase values were enrolled. Collected baseline data included demographic characteristics and clinical and laboratory measurements. All patients were followed until December 31, 2012. The associations of total serum alkaline phosphatase levels with all-cause and cardiovascular mortality were assessed using multivariable-adjusted Cox models.

RESULTS

Of 1021 patients, mean age was 47.5 (± 15.5) years, 59.1% of patients were men, and 22.8% of patients were diabetic. The median serum alkaline phosphatase level was 64 U/L (interquartile range=52-82 U/L). During a median 31-month (interquartile range=19-45 months) follow-up period, 203 patients died, of which 109 deaths were caused by cardiovascular disease. After adjusting for demographics, comorbid conditions, liver function, and bone metabolism parameters, the highest alkaline phosphatase quartile was significantly associated with a hazard ratio for all-cause mortality of 1.70 (95% confidence interval, 1.06 to 2.74, P=0.03) and a hazard ratio for cardiovascular mortality of 1.94 (95% confidence interval, 1.02 to 3.72, P=0.04). Each 10 U/L higher baseline alkaline phosphatase level was associated with 4% (95% confidence interval, 1.00 to 1.08, P=0.04) and 7% (95% confidence interval, 1.02 to 1.11, P=0.003) higher risk of all-cause and cardiovascular mortality, respectively.

CONCLUSION

Higher total serum alkaline phosphatase levels at the commencement of peritoneal dialysis were independently associated with all-cause and cardiovascular mortality in peritoneal dialysis patients.

Authors+Show Affiliations

Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health, Guangdong, China.No 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)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24458081

Citation

Liu, Xinhui, et al. "Alkaline Phosphatase and Mortality in Patients On Peritoneal Dialysis." Clinical Journal of the American Society of Nephrology : CJASN, vol. 9, no. 4, 2014, pp. 771-8.
Liu X, Guo Q, Feng X, et al. Alkaline phosphatase and mortality in patients on peritoneal dialysis. Clin J Am Soc Nephrol. 2014;9(4):771-8.
Liu, X., Guo, Q., Feng, X., Wang, J., Wu, J., Mao, H., Huang, F., Yu, X., & Yang, X. (2014). Alkaline phosphatase and mortality in patients on peritoneal dialysis. Clinical Journal of the American Society of Nephrology : CJASN, 9(4), 771-8. https://doi.org/10.2215/CJN.08280813
Liu X, et al. Alkaline Phosphatase and Mortality in Patients On Peritoneal Dialysis. Clin J Am Soc Nephrol. 2014;9(4):771-8. PubMed PMID: 24458081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alkaline phosphatase and mortality in patients on peritoneal dialysis. AU - Liu,Xinhui, AU - Guo,Qunying, AU - Feng,Xiaoran, AU - Wang,Juan, AU - Wu,Juan, AU - Mao,Haiping, AU - Huang,Fengxian, AU - Yu,Xueqing, AU - Yang,Xiao, Y1 - 2014/01/23/ PY - 2014/1/25/entrez PY - 2014/1/25/pubmed PY - 2015/1/7/medline SP - 771 EP - 8 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 9 IS - 4 N2 - BACKGROUND AND OBJECTIVES: Elevated total serum alkaline phosphatase levels have been associated with higher mortality in the general population, CKD patients, and hemodialysis patients. However, in peritoneal dialysis patients, this association has received little attention. The aim of this study was to evaluate the association between alkaline phosphatase and all-cause and cardiovascular mortality in peritoneal dialysis patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this single center retrospective cohort study, 1021 incident peritoneal dialysis patients from January 1, 2006, to December 31, 2010 with baseline serum alkaline phosphatase values were enrolled. Collected baseline data included demographic characteristics and clinical and laboratory measurements. All patients were followed until December 31, 2012. The associations of total serum alkaline phosphatase levels with all-cause and cardiovascular mortality were assessed using multivariable-adjusted Cox models. RESULTS: Of 1021 patients, mean age was 47.5 (± 15.5) years, 59.1% of patients were men, and 22.8% of patients were diabetic. The median serum alkaline phosphatase level was 64 U/L (interquartile range=52-82 U/L). During a median 31-month (interquartile range=19-45 months) follow-up period, 203 patients died, of which 109 deaths were caused by cardiovascular disease. After adjusting for demographics, comorbid conditions, liver function, and bone metabolism parameters, the highest alkaline phosphatase quartile was significantly associated with a hazard ratio for all-cause mortality of 1.70 (95% confidence interval, 1.06 to 2.74, P=0.03) and a hazard ratio for cardiovascular mortality of 1.94 (95% confidence interval, 1.02 to 3.72, P=0.04). Each 10 U/L higher baseline alkaline phosphatase level was associated with 4% (95% confidence interval, 1.00 to 1.08, P=0.04) and 7% (95% confidence interval, 1.02 to 1.11, P=0.003) higher risk of all-cause and cardiovascular mortality, respectively. CONCLUSION: Higher total serum alkaline phosphatase levels at the commencement of peritoneal dialysis were independently associated with all-cause and cardiovascular mortality in peritoneal dialysis patients. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/24458081/Alkaline_phosphatase_and_mortality_in_patients_on_peritoneal_dialysis_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=24458081 DB - PRIME DP - Unbound Medicine ER -