Dataset Information

Low serum calcium is associated with poor renal outcomes in chronic kidney disease stages 3-4 patients.

ABSTRACT:

Background

Mineral disorders are associated with adverse renal outcomes in chronic kidney disease (CKD) patients. Previous studies have associated hypercalcemia and hypocalcemia with mortality; however, the association between serum calcium and renal outcome is not well-described. Whether adding calcium besides phosphorus or in the form of calcium-phosphorus (Ca×P) product into the model of survival analysis could improve the prediction of renal outcomes is not known.

Methods

A prospective cohort of 2144 outpatients with CKD stages 3-4 was evaluated. Cox proportional hazard analysis was performed according to calcium quartiles.

Results

The mean calcium level was 9.2±0.7 mg/dL. Low serum calcium (<9.0 mg/dL) was associated with increased risk of requiring renal replacement therapy (RRT) (hazards ratio [HR]:2.12 (95% CI: 1.49-3.02, P<0.05) and rapid renal function progression (odds ratio [OR]: 1.65 (95% CI: 1.19-2.27, P<0.05) compared with high serum calcium (>9.8 mg/dL). Adding calcium into the survival model increased the integrated discrimination improvement by 0.80% (0.12%-1.91%) while calcium-phosphorus product did not improve risk prediction.The combination of high serum phosphorus (>4.2 mg/dL) and low serum calcium (<9.1 mg/dL) was associated with the highest risk of RRT (HR:2.31 (95% CI: 1.45-3.67, P<0.05).

Conclusion

Low serum calcium is associated with increased risk of RRT and rapid renal function progression in CKD stage 3-4 patients. The integration of serum calcium and phosphorus, but not calcium-phosphorus product should be considered in a predictive model of renal outcome.

SUBMITTER: Lim LM

PROVIDER: S-EPMC4255427 | biostudies-literature | 2014 Nov

REPOSITORIES: biostudies-literature

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Publications

Low serum calcium is associated with poor renal outcomes in chronic kidney disease stages 3-4 patients.

Lim Lee-Moay LM Kuo Hung-Tien HT Kuo Mei-Chuan MC Chiu Yi-Wen YW Lee Jia-Jung JJ Hwang Shang-Jyh SJ Tsai Jer-Chia JC Hung Chi-Chih CC Chen Hung-Chun HC

BMC nephrology 20141121

<h4>Background</h4>Mineral disorders are associated with adverse renal outcomes in chronic kidney disease (CKD) patients. Previous studies have associated hypercalcemia and hypocalcemia with mortality; however, the association between serum calcium and renal outcome is not well-described. Whether adding calcium besides phosphorus or in the form of calcium-phosphorus (Ca×P) product into the model of survival analysis could improve the prediction of renal outcomes is not known.<h4>Methods</h4>A pr ...[more]

PMID: 25412875

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Dataset Information

Low serum calcium is associated with poor renal outcomes in chronic kidney disease stages 3-4 patients.

Background

Methods

Results

Conclusion

Publications

Low serum calcium is associated with poor renal outcomes in chronic kidney disease stages 3-4 patients.

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