Abstract
Dialysis patients have remarkable low survival rates, and various factors may have a significant role on this issue. Monitoring of parameters such as mineral and bone disorder (MBD) biomarkers seems to be beneficial for these patients. Homeostasis of such markers and the physiology of CKD can be affected by race, epidemiology and various environmental factors. There is poor evidence in Middle East studies on the association of changes in these parameters and mortality in dialysis patients. This is a five-year retrospective cohort study, which is part of HD-MORF study (Hemodialysis mortality risk factors). Demographic and quarterly laboratory data of 824 patients in 6 hemodialysis centers in our province were extracted from the medical records of the patients. We evaluated adults on chronic hemodialysis (over 3 months) between September 2012 and September 2017. The parameters that was recorded include serum calcium, phosphorus, iPTH and Alkaline phosphatase (ALP). Kaplan-Meier and Cox regression analyses were performed to build models for predicting patients' five-year survival. Average 5-year follow-up duration was 21.77 ± 15.77 months for non-survivors and 24.72 ± 18.42 for the survivors. The mortality of patients during 5 years observation was 177 (21.4%) patients (non-survivors). The parameters hazard ratios of death calculated by Cox regression test are showed in Table 1. Lower serum levels of calcium (p<0.001), and higher levels of ALP (p<0.001) and PTH (p<0.001) are significantly associated with lower survival. Phosphate level was not related to patients’ survival (p=0.56).View Large Image Figure ViewerDownload Hi-res image Download (PPT) Calcium, ALP and iPTH are of paramount importance in hemodialysis patients. Survival of dialysis patients seems to be determined by a set of causal factors and combined models may have predictive value.
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