CDC STACKS serves as an archival repository of CDC-published products including scientific findings, journal articles, guidelines, recommendations, or other public health information authored or co-authored by CDC or funded partners.
As a repository, CDC STACKS retains documents in their original published format to ensure public access to scientific information.
i
Prognostic Importance of Serum Alkaline Phosphatase in CKD Stages 3–4 in a Clinical Population
-
Jun 12 2013
-
-
Source: Am J Kidney Dis. 2013; 62(4):703-710.
[PDF-515.43 KB]
Details:
-
Alternative Title:Am J Kidney Dis
-
Personal Author:
-
Description:Background
Elevated total serum alkaline phosphatase (ALP) levels have been associated with mortality in the general population and in dialysis patients.
Study Design
Retrospective cohort study.
Setting & Participants
28,678 patients with chronic kidney disease (CKD) stages 3 and 4 (estimated glomerular filtration rate [eGFR], 15–59 ml/min/1.73 m2) were identified using the Cleveland Clinic Chronic Kidney Disease Registry. CKD was defined as two eGFR values <60 ml/min/1.73 m2 drawn >90 days apart using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation.
Predictor
ALP levels measured using the calorimetric assay was examined as quartiles (quartile 1, <66 U/L; Q2, 66–81 U/L; Q3, 82–101 U/L; and Q4, ≥102 U/L) and as a continuous measure.
Outcomes & Measurements
All-cause mortality and ESRD were ascertained using the Social Security Death Index and US Renal Data System.
Results
After a median follow up of 2.2 years, 588 patients progressed to ESRD and 4,755 died. There was a graded increase in the risk for mortality with higher ALP quartiles (Q2, Q3, Q4) when compared to the reference quartile (Q1) after adjusting for demographics, comorbid conditions, use of relevant medications and liver function tests. The highest quartile of ALP was associated with a hazard ratio for ESRD of 1.38 (95% CI, 1.09–1.76). Each 1-standard deviation (42.7 U/L) higher ALP level was associated with 15% (95% CI, 1.09–1.22) and 16% (95% CI, 1.14–1.18) increased risk of ESRD and mortality respectively.
Limitations
Single center observational study, lack complete data including PTH for all study participants and attrition bias.
Conclusions
Higher serum ALP levels in CKD stages 3–4 were independently associated with all-cause mortality and ESRD.
-
Subjects:
-
Source:
-
Pubmed ID:23769134
-
Pubmed Central ID:PMC3783514
-
Document Type:
-
Funding:
-
Volume:62
-
Issue:4
-
Collection(s):
-
Main Document Checksum:
-
Download URL:
-
File Type:
