Serum alkaline phosphatase levels correlate with long-term mortality solely in peritoneal dialysis patients with residual renal function

Autor: Yu Wang, Qinglan Hu, Xiaojiang Zhan, Yuting Yang, Panlin Qiu, Siyi Liu, Yanbing Chen, Qinkai Chen, Jun Xiao, Li Zhang, Xin Wei, Caixia Yan
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
030232 urology & nephrology
Renal function
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
Kidney
urologic and male genital diseases
Critical Care and Intensive Care Medicine
Gastroenterology
Peritoneal dialysis
03 medical and health sciences
0302 clinical medicine
Internal medicine
Humans
Medicine
In patient
Increased serum alkaline phosphatase
Serum alkaline phosphatase
Retrospective Studies
business.industry
General Medicine
Middle Aged
residual renal function
Alkaline Phosphatase
Diseases of the genitourinary system. Urology
Survival Rate
peritoneal dialysis
Nephrology
Clinical Study
long-term mortality
Kidney Failure
Chronic
Alkaline phosphatase
Female
Long term mortality
RC870-923
business
Follow-Up Studies
Glomerular Filtration Rate
Zdroj: Renal Failure
Renal Failure, Vol 41, Iss 1, Pp 718-725 (2019)
ISSN: 1525-6049
0886-022X
DOI: 10.1080/0886022x.2019.1646662
Popis: Introduction: Increased serum alkaline phosphatase (ALP) is predictive of a higher mortality in patients with end-stage renal disease. However, it remains unknown whether residual renal function (RRF) influences the outcome-association of serum ALP among peritoneal dialysis (PD) patients. Methods: A total of 650 incident PD patients receiving PD catheter implantation in an institute between 1 November 2005 and 28 February 2017 were retrospectively enrolled. These patients were divided into groups with and without RRF (RRF and non-RRF groups) and those with serum ALP levels in tertiles. The Kaplan–Meier method and multivariate Cox proportional hazard models were used to analyze their outcomes based on RRF and serum ALP levels. Results: These 650 patients had a mean age of 49.4 ± 14.0 years old, their median ALP level was 74 U/L (interquartile range (IQR): 59–98). After 28-month (IQR: 14–41) follow-up, 80 patients in RRF group and 40 patients in non-RRF group died. PD patients with the highest serum ALP tertile had significant lower survival (p = .014), when compared to other patients in the RRF group. However, this relationship was not observed in patients in the non-RRF group. After multivariate adjustment, in the RRF group, patients with the highest ALP tertile had a significantly higher risk of mortality (hazard ratio (HR): 2.26, 95% confidence interval (CI): 1.06–4.82, p = .034). Each 10-U/L increase in ALP level was associated with a 4% (HR: 1.04, 95% CI: 1.00–1.08, p = .045) higher mortality risk. Conclusions: Higher serum ALP level is associated with increased mortality solely in PD patients with RRF.
Databáze: OpenAIRE
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