Patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort study
Abstract In hemodialysis patients, it remains unclear whether patient characteristics influence the clinical impacts of changes in serum mineral metabolism parameters on mortality. In this 9-year cohort study, we investigated the associations between the changes in calcium/phosphate levels and all-c...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-03-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-92359-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850251930819887104 |
|---|---|
| author | Shunsuke Goto Takayuki Hamano Masatomo Taniguchi Masanori Abe Kosaku Nitta Shinichi Nishi Hideki Fujii |
| author_facet | Shunsuke Goto Takayuki Hamano Masatomo Taniguchi Masanori Abe Kosaku Nitta Shinichi Nishi Hideki Fujii |
| author_sort | Shunsuke Goto |
| collection | DOAJ |
| description | Abstract In hemodialysis patients, it remains unclear whether patient characteristics influence the clinical impacts of changes in serum mineral metabolism parameters on mortality. In this 9-year cohort study, we investigated the associations between the changes in calcium/phosphate levels and all-cause mortality using a time-dependent approach after adjustment for potential confounders in groups stratified by performance status (PS), a history of atherosclerotic cardiovascular disease (ACVD), or diabetic nephropathy (DN). In patients with baseline serum calcium levels of 9.5–<10.0 mg/dL, increases in serum calcium levels were associated with higher mortality exclusively in patients with PS Grade 0. In the same baseline calcium range, a significant association was observed between reduced serum calcium levels and lower mortality only in patients with a history of ACVD or DN. Similarly, in patients with baseline serum phosphate levels of 5.0–<5.5 mg/dL, reduced serum phosphate levels were associated with lower mortality only in those with PS Grade 0, a history of ACVD or DN. These findings indicate that PS should be considered in treating mild hypercalcemia or hyperphosphatemia in hemodialysis patients. Moreover, stringent management of hypercalcemia and hyperphosphatemia in patients with a history of ACVD or DN might be associated with a better prognosis. |
| format | Article |
| id | doaj-art-b85fafca4f4c4f37b068fdd4c8ea5187 |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-b85fafca4f4c4f37b068fdd4c8ea51872025-08-20T01:57:47ZengNature PortfolioScientific Reports2045-23222025-03-0115111410.1038/s41598-025-92359-0Patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort studyShunsuke Goto0Takayuki Hamano1Masatomo Taniguchi2Masanori Abe3Kosaku Nitta4Shinichi Nishi5Hideki Fujii6Committee of the Renal Data Registry, Japanese Society for Dialysis TherapyDepartment of Nephrology, Nagoya City University, Graduate School of Medical SciencesCommittee of the Renal Data Registry, Japanese Society for Dialysis TherapyCommittee of the Renal Data Registry, Japanese Society for Dialysis TherapyCommittee of the Renal Data Registry, Japanese Society for Dialysis TherapyDivision of Nephrology and Kidney Center, Kobe University Graduate School of MedicineDivision of Nephrology and Kidney Center, Kobe University Graduate School of MedicineAbstract In hemodialysis patients, it remains unclear whether patient characteristics influence the clinical impacts of changes in serum mineral metabolism parameters on mortality. In this 9-year cohort study, we investigated the associations between the changes in calcium/phosphate levels and all-cause mortality using a time-dependent approach after adjustment for potential confounders in groups stratified by performance status (PS), a history of atherosclerotic cardiovascular disease (ACVD), or diabetic nephropathy (DN). In patients with baseline serum calcium levels of 9.5–<10.0 mg/dL, increases in serum calcium levels were associated with higher mortality exclusively in patients with PS Grade 0. In the same baseline calcium range, a significant association was observed between reduced serum calcium levels and lower mortality only in patients with a history of ACVD or DN. Similarly, in patients with baseline serum phosphate levels of 5.0–<5.5 mg/dL, reduced serum phosphate levels were associated with lower mortality only in those with PS Grade 0, a history of ACVD or DN. These findings indicate that PS should be considered in treating mild hypercalcemia or hyperphosphatemia in hemodialysis patients. Moreover, stringent management of hypercalcemia and hyperphosphatemia in patients with a history of ACVD or DN might be associated with a better prognosis.https://doi.org/10.1038/s41598-025-92359-0CalciumDiabetes mellitusHemodialysisPerformance statusPhosphate |
| spellingShingle | Shunsuke Goto Takayuki Hamano Masatomo Taniguchi Masanori Abe Kosaku Nitta Shinichi Nishi Hideki Fujii Patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort study Scientific Reports Calcium Diabetes mellitus Hemodialysis Performance status Phosphate |
| title | Patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort study |
| title_full | Patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort study |
| title_fullStr | Patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort study |
| title_full_unstemmed | Patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort study |
| title_short | Patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort study |
| title_sort | patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort study |
| topic | Calcium Diabetes mellitus Hemodialysis Performance status Phosphate |
| url | https://doi.org/10.1038/s41598-025-92359-0 |
| work_keys_str_mv | AT shunsukegoto patientcharacteristicsmodifytheassociationbetweenchangesinmineralmetabolismparametersandmortalityinanationwidehemodialysiscohortstudy AT takayukihamano patientcharacteristicsmodifytheassociationbetweenchangesinmineralmetabolismparametersandmortalityinanationwidehemodialysiscohortstudy AT masatomotaniguchi patientcharacteristicsmodifytheassociationbetweenchangesinmineralmetabolismparametersandmortalityinanationwidehemodialysiscohortstudy AT masanoriabe patientcharacteristicsmodifytheassociationbetweenchangesinmineralmetabolismparametersandmortalityinanationwidehemodialysiscohortstudy AT kosakunitta patientcharacteristicsmodifytheassociationbetweenchangesinmineralmetabolismparametersandmortalityinanationwidehemodialysiscohortstudy AT shinichinishi patientcharacteristicsmodifytheassociationbetweenchangesinmineralmetabolismparametersandmortalityinanationwidehemodialysiscohortstudy AT hidekifujii patientcharacteristicsmodifytheassociationbetweenchangesinmineralmetabolismparametersandmortalityinanationwidehemodialysiscohortstudy |