Publication:
Impact of age on survival predictability of bone turnover markers in hemodialysis patients

0
0

Issued Date

2013

Resource Type

Article

File Type

application/pdf

ISSN

9310509

DOI

10.1093/ndt/gft290

Other identifier(s)

2-s2.0-84884958861

Rights Holder(s)

Scopus

Bibliographic Citation

Nephrology Dialysis Transplantation. Vol 28, No.10 (2013), p.2535-2545

Suggested Citation

Lertdumrongluk P., Lau W.L., Park J., Rhee C.M., Kovesdy C.P., Kalantar-Zadeh K. Impact of age on survival predictability of bone turnover markers in hemodialysis patients. Nephrology Dialysis Transplantation. Vol 28, No.10 (2013), p.2535-2545. doi:10.1093/ndt/gft290 Retrieved from: https://hdl.handle.net/20.500.14740/6547

Title

Impact of age on survival predictability of bone turnover markers in hemodialysis patients

Author(s)

Lertdumrongluk P.
 Lau W.L.
 Park J.
 Rhee C.M.
 Kovesdy C.P.
 Kalantar-Zadeh K.

Abstract

BackgroundAbnormalities in serum alkaline phosphatase (ALP) and intact parathyroid hormone (PTH) concentrations, as biochemical markers of bone turnover in dialysis patients, correlate with increased mortality in maintenance hemodialysis (MHD) patients. Changes in bone turnover rate vary with age. The mortality predictability of serum ALP and PTH levels in MHD patients may be different across ages.MethodsWe examined differences across four age groups (18 to <45, 45 to <65, 65 to <75 and ≥75 years) in the mortality predictability of serum ALP and PTH in 102 149 MHD patients using Cox models.ResultsHigher serum ALP levels were associated with higher mortality across all ages; however, the ALP-mortality association was much stronger in young patients (<45 years) compared with older patients. The association between higher serum PTH levels and mortality was stronger in older patients compared with the younger groups. Serum PTH levels were incrementally associated with mortality only in middle-aged and elderly patients (≥45 years). Compared with patients with serum PTH 150 to <300pg/mL, the death risks were higher in patients with serum PTH 300 to <600pg/mL [HRs (95% CI): 1.05 (1.01-1.10), 1.15 (1.10-1.21) and 1.25 (1.19-1.31) for patients 45 to <65, 65 to <75 and ≥75 years, respectively], and ≥600pg/mL [HRs(95% CI): 1.07 (1.01-1.14), 1.31(1.21-1.42) and 1.45(1.33-1.59) for age categories 45 to <65, 65 to <75 and ≥75 years, respectively]. However, no significant association between higher serum PTH levels and mortality was observed in patients <45 years.ConclusionsThere are important differences in mortality-predictability of serum ALP and PTH in older MHD patients compared with their younger counterparts. The effect of age needs to be considered when interpreting the prognostic implications of serum ALP and PTH levels. © 2013 The Author. All rights reserved.

Subject(s)

Albumin
 Alkaline phosphatase
 Creatinine
 Parathyroid hormone
 Adult
 Age distribution
 Aged
 Albumin blood level
 Alkaline phosphatase blood level
 Article
 Body mass
 Bone turnover
 Cardiovascular mortality
 Cohort analysis
 Creatinine blood level
 Disease association
 Female
 Groups by age
 Hemodialysis patient
 Human
 Major clinical study
 Male
 Parathyroid hormone blood level
 Priority journal
 Retrospective study
 Age
 Alkaline phosphatase
 Bone turnover markers
 Hemodialysis
 Parathyroid hormone
 Adolescent
 Adult
 Age Factors
 Aged
 Aged, 80 and over
 Alkaline Phosphatase
 Biological Markers
 Bone and Bones
 Bone Remodeling
 Female
 Follow-Up Studies
 Glomerular Filtration Rate
 Humans
 Kidney Diseases
 Kidney Function Tests
 Male
 Middle Aged
 Parathyroid Hormone
 Prognosis
 Renal Dialysis
 Survival Rate
 Young Adult

View online Resources

Research Projects

Organizational Units

Journal Issue

URI

https://hdl.handle.net/20.500.14740/6547

Collections

Scopus: Year 1983-2021

Endorsement

Review

Supplemented By

Referenced By