Serum alkaline phosphatase and mortality in hemodialysis patients.

Clinical Nephrology
S BeddhuT Greene

Abstract

Alkaline phosphatase is typically considered as an innocent by-stander, but emerging data suggest that alkaline phosphatase might play a pathogenic role in vascular calcification and thus contribute to increased mortality in hemodialysis patients. Longitudinal analyses of the existing HEMO Study database. 1,827 HEMO Study participants. Serum alkaline phosphatase level. OUTCOME AND MEASUREMENTS: All-cause and cardiovascular mortality. Based on the median serum alkaline phosphatase of 97 IU/l, participants were divided into low (< 97 IU/l) and high (> or = 97 IU/l) serum alkaline phosphatase groups. The lower serum alkaline phosphatase group was associated with older age, male gender, non-black race and shorter dialysis years as well as higher serum calcium, higher serum calcium-phosphorus product and lower parathyroid hormone levels. Mean serum liver enzyme values were in the normal range in both groups, but the high alkaline phosphatase group had slightly higher values. In a multivariate time-dependent Cox model using baseline and follow-up values of serum alkaline phosphatase levels, adjusted for demographics, HEMO Study groups, comorbidity, bone metabolism parameters and liver enzymes, each doubling of serum alkaline phosphat...Continue Reading

Citations

Sep 12, 2012·International Urology and Nephrology·Usama ElewaAlberto Ortiz
Nov 3, 2011·Nature Reviews. Nephrology·Alberto OrtizCarmine Zoccali
Nov 6, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Rebecca FilipowiczSrinivasan Beddhu
Mar 4, 2014·International Journal of Epidemiology·Setor K KunutsorJohn Walley
Mar 15, 2019·Arteriosclerosis, Thrombosis, and Vascular Biology·Ekaterina S KaretnikovaRoman N Rodionov
Jan 25, 2014·Clinical Journal of the American Society of Nephrology : CJASN·Xinhui LiuXiao Yang
May 24, 2016·The Cochrane Database of Systematic Reviews·Suetonia C PalmerGiovanni F M Strippoli
Jan 5, 2014·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Connie M RheeKamyar Kalantar-Zadeh
May 5, 2020·Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis·Zhimin ChenJianghua Chen
May 16, 2017·Nature Reviews. Nephrology·Mathias HaarhausPer Magnusson

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