Abstract
BackgroundWe aimed to examine the association of three mineral metabolism markers, including serum calcium, inorganic phosphorus, and intact parathyroid hormone with the risk of chronic kidney disease (CKD) at all stages.MethodsThis retrospective cohort study involved 3563 participants, including 3274 CKD patients and 289 healthy controls. CKD is diagnosed according to clinical guidelines from the 2012 KDIGO. Effect sizes are expressed odds ratio (OR) and 95 confidence interval (CI).ResultsAfter propensity score matching, per 0.5 mg/dL increment of inorganic phosphorus was significantly associated with 1.33-, 1.61-, and 2.85-fold increased risk of CKD at stages 1–2, 4, and 5, respectively. Regarding per 8 pg/mL increment of intact parathyroid hormone, significance was only noted for stage 5. In subsidiary analyses, the risk prediction of mineral metabolism markers under study was more evident in males and hypertensive subjects. A nomogram prediction model was constructed based on age, sex, and three mineral metabolism markers for CKD, with decent accuracy.ConclusionsOur findings indicate that serum calcium was associated with all-stage CKD risk, whereas the association for inorganic phosphorus and intact parathyroid hormone was significant at advanced stages.
Highlights
Chronic kidney disease constitutes a worldwide health problem due to its high prevalence and absolute burden
Serum calcium concentrations were consistently lower in cases with chronic kidney disease (CKD) at all stages than controls, yet the concentrations of intact parathyroid hormone were consistently higher
Taking stage 4 as an example, assuming a men aged 45 years old (20 points) with serum calcium of 8 mg/dL (25 points), inorganic phosphorus of 6 mg/dL (42 points), intact parathyroid hormone of 100 pg/mL (20 points), the probability of having stage 4 CKD was estimated to be 90%. The aim of this retrospective study was to examine the association of three mineral metabolism markers with risk of different stages of CKD among Chinese adults
Summary
Chronic kidney disease constitutes a worldwide health problem due to its high prevalence and absolute burden. Evidence from clinical and epidemiologic studies indicates that abnormalities of mineral metabolism, such as secondary hyperparathyroidism, hyperphosphatemia, and hypocalcemia, are commonly seen in patients with kidney failure and are associated with an increased risk. We aimed to examine the association of three mineral metabolism markers, including serum calcium, inorganic phosphorus, and intact parathyroid hormone with the risk of chronic kidney disease (CKD) at all stages. Results After propensity score matching, per 0.5 mg/dL increment of inorganic phosphorus was significantly associated with 1.33-, 1.61-, and 2.85-fold increased risk of CKD at stages 1–2, 4, and 5, respectively. Conclusions Our findings indicate that serum calcium was associated with all-stage CKD risk, whereas the association for inorganic phosphorus and intact parathyroid hormone was significant at advanced stages
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