An elevated serum level of alkaline phosphatase is associated with an increased risk of death in patients on maintenance hemodialysis, according to a report in the July 30th online issue of the Journal of the American Society of Nephrology.
"This large epidemiologic study shows, for the first time, a consistent and robust association between a high blood level of alkaline phosphatase and cardiovascular death in thousands of dialysis patients across the US," senior author Dr. Kamyar Kalantar-Zadeh, from the University of California, Los Angeles, said in a statement.
The findings from the study, a 3-year investigation of 73,960 dialysis patients, show a direct association between alkaline phosphatase levels and both all-cause and cardiovascular mortality.
After adjusting for demographics, comorbidity, minerals, parathyroid hormone, and other factors, an alkaline phosphatase level of 120 U/L or higher was associated with a mortality hazard ratio of 1.25 (p < 0.001). Moreover, the association was apparent among a variety of patient subgroups, including subjects with anti-hepatitis C antibodies.
Temporal trends in risk were also identified, the report indicates. For each 10 U/L-increase in alkaline phosphatase during the first 6 months, the risk of death during the remaining study period increased incrementally.
"If the association between alkaline phosphatase and mortality has a causal link, treatment strategies that reduce alkaline phosphatase levels may improve survival in patients with chronic kidney disease, and probably in many other patients with chronic diseases and active bone disorders," Dr. Kalantar-Zadeh said. |
