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Abstract: TH-PO194

Association of Serum Mineral Parameters with Mortality in Hemodialysis Patients: Data Analysis from Korean ESRD Registry

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Kim, Yunmi, Dongguk University Gyeongju Hospital, Gyeongsangbuk-do, Korea (the Republic of)
  • Yoo, Kyung Don, Dongguk University Gyeongju Hospital, Gyeongsangbuk-do, Korea (the Republic of)
  • Kim, Hyo Jin, Dongguk University College of Medicine, Gyeongju-si, GyeongSangBuk-do, Korea (the Republic of)
  • Koh, Junga, Gangneung Dongin Hospital, Gangneung-si, Gangwon-do, Korea (the Republic of)
  • Yu, Yeonsil, JHospital, Seongnam-si, Korea (the Republic of)
  • Kim, Yeong Hoon, Inje University Medical School, Busan, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background

We investigated the association between mineral metabolism parameters and mortality in Korean hemodialysis patients to identify optimal targets in Korean population.

Methods

Among hemodialysis patients registered in the End-stage renal disease Registry of the Korean Society of Nephrology between March 2012 and June 2017, those with serum calcium, phosphorus, and intact parathyroid hormone (iPTH) measured at enrollment were included. Analysis for the association of serum levels of calcium, phosphorus, and iPTH with all-cause mortality was conducted.

Results

Among the total 21,433 enrolled patients, 3,135 (14.6%) patients died during 24.8 ± 14.5 months follow-up period. After multivariable adjustment, patients in the 1st quintile of corrected calcium was associated with lower mortality (HR, 0.84; 95% CI, 0.71-0.99; P=0.003), while those in the 5th quintile of corrected calcium was associated with higher mortality (HR, 1.39; 95% CI, 1.20-1.61; P<0.001) compared with those in the 3rd quintile. For phosphorus, only the lowest quintile was significantly associated with increased mortality (HR, 1.24; 95% CI, 1.08-1.43; P=0.003). The lowest (HR, 1.18; 95% CI, 1.02-1.36; P=0.026) and the highest quintile of iPTH (HR, 1.24; 95% CI, 1.05-1.46; P=0.013) were associated with increased mortality. Regarding target counts achieved according to the KDOQI guideline, patients who achieved none of the mineral parameter targets had higher mortality than those who achieved all of the 3 targets (HR, 1.37; 95% CI, 1.12-1.67; P=0.003).

Conclusion

In Korean hemodialysis patients, high serum calcium, low phosphorus, as well as high and low iPTH levels were associated with increased all-cause mortality.