Prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre-dialysis chronic kidney disease patients with mineral and bone disorder
Introduction: Chronic kidney disease-mineral and bone disease (CKD-MBD) is a complication of chronic kidney disease (CKD) involving derangements in serum calcium and phosphate. This study aims to evaluate hypo- and hypercalcaemia and their associated outcomes among pre-dialysis CKD patients. Methods...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer – Medknow Publications
2024-08-01
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| Series: | Singapore Medical Journal |
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| Online Access: | https://journals.lww.com/10.4103/singaporemedj.SMJ-2021-391 |
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| author | Mei Hui Amanda Yong Jun Jie Benjamin Seng Ying Lin Cheryl Tan Jiunn Wong Priscilla How |
| author_facet | Mei Hui Amanda Yong Jun Jie Benjamin Seng Ying Lin Cheryl Tan Jiunn Wong Priscilla How |
| author_sort | Mei Hui Amanda Yong |
| collection | DOAJ |
| description | Introduction:
Chronic kidney disease-mineral and bone disease (CKD-MBD) is a complication of chronic kidney disease (CKD) involving derangements in serum calcium and phosphate. This study aims to evaluate hypo- and hypercalcaemia and their associated outcomes among pre-dialysis CKD patients.
Methods:
A retrospective cohort study was performed and included all adult CKD stage 4–stage 5 patients who were on treatment for CKD-MBD between 2016 and 2017. Each patient was followed up for 3 years. Hypo- and hypercalcaemia were defined as serum corrected calcium (Ca2+) <2.10 and >2.46 mmol/L, respectively. Outcomes evaluated included all-cause mortality and cardiovascular events. Multivariate Cox regression analysis was done to evaluate the association of hypocalcaemia and/or hypercalcaemia with the clinical outcomes. Severity of hypocalcaemia episode was classified as ‘mild’ (Ca2+: between 1.90 and 2.10 mmol/L) and ‘severe’ (Ca2+: <1.90 mmol/L). Severity of hypercalcaemia was classified as ‘mild’ (Ca2+: between 2.47 and 3.00 mmol/L), moderate (Ca2+: between 3.01 and 3.50 mmol/L) and severe (Ca2+: >3.50 mmol/L).
Results:
Of the 400 patients, 169 (42.2%) and 94 (23.5%) patients experienced hypocalcaemia and hypercalcaemia, respectively. Severe hypocalcaemia was more prevalent in CKD stage 5 compared to CKD stage 4 (96 [40.5%] vs. 36 [25.9%], P = 0.004). Results from multivariate analyses after adjustment showed that hypocalcaemia and/or hypercalcaemia were not associated with all-cause mortality (P > 0.05) or the occurrence of cardiovascular events (P > 0.05).
Conclusion:
Hypocalcaemia and hypercalcaemia episodes were prevalent among pre-dialysis CKD patients. Studies with longer follow-up durations are required to assess the effects of calcium derangements on clinical outcomes. |
| format | Article |
| id | doaj-art-df55d083e7344dc09570a2bfe7ef953e |
| institution | Kabale University |
| issn | 0037-5675 2737-5935 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | Wolters Kluwer – Medknow Publications |
| record_format | Article |
| series | Singapore Medical Journal |
| spelling | doaj-art-df55d083e7344dc09570a2bfe7ef953e2025-02-09T10:23:48ZengWolters Kluwer – Medknow PublicationsSingapore Medical Journal0037-56752737-59352024-08-0165842142910.4103/singaporemedj.SMJ-2021-391Prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre-dialysis chronic kidney disease patients with mineral and bone disorderMei Hui Amanda YongJun Jie Benjamin SengYing Lin Cheryl TanJiunn WongPriscilla HowIntroduction: Chronic kidney disease-mineral and bone disease (CKD-MBD) is a complication of chronic kidney disease (CKD) involving derangements in serum calcium and phosphate. This study aims to evaluate hypo- and hypercalcaemia and their associated outcomes among pre-dialysis CKD patients. Methods: A retrospective cohort study was performed and included all adult CKD stage 4–stage 5 patients who were on treatment for CKD-MBD between 2016 and 2017. Each patient was followed up for 3 years. Hypo- and hypercalcaemia were defined as serum corrected calcium (Ca2+) <2.10 and >2.46 mmol/L, respectively. Outcomes evaluated included all-cause mortality and cardiovascular events. Multivariate Cox regression analysis was done to evaluate the association of hypocalcaemia and/or hypercalcaemia with the clinical outcomes. Severity of hypocalcaemia episode was classified as ‘mild’ (Ca2+: between 1.90 and 2.10 mmol/L) and ‘severe’ (Ca2+: <1.90 mmol/L). Severity of hypercalcaemia was classified as ‘mild’ (Ca2+: between 2.47 and 3.00 mmol/L), moderate (Ca2+: between 3.01 and 3.50 mmol/L) and severe (Ca2+: >3.50 mmol/L). Results: Of the 400 patients, 169 (42.2%) and 94 (23.5%) patients experienced hypocalcaemia and hypercalcaemia, respectively. Severe hypocalcaemia was more prevalent in CKD stage 5 compared to CKD stage 4 (96 [40.5%] vs. 36 [25.9%], P = 0.004). Results from multivariate analyses after adjustment showed that hypocalcaemia and/or hypercalcaemia were not associated with all-cause mortality (P > 0.05) or the occurrence of cardiovascular events (P > 0.05). Conclusion: Hypocalcaemia and hypercalcaemia episodes were prevalent among pre-dialysis CKD patients. Studies with longer follow-up durations are required to assess the effects of calcium derangements on clinical outcomes.https://journals.lww.com/10.4103/singaporemedj.SMJ-2021-391chronic kidney diseaseclinical outcomeshypercalcaemiahypocalcaemia |
| spellingShingle | Mei Hui Amanda Yong Jun Jie Benjamin Seng Ying Lin Cheryl Tan Jiunn Wong Priscilla How Prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre-dialysis chronic kidney disease patients with mineral and bone disorder Singapore Medical Journal chronic kidney disease clinical outcomes hypercalcaemia hypocalcaemia |
| title | Prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre-dialysis chronic kidney disease patients with mineral and bone disorder |
| title_full | Prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre-dialysis chronic kidney disease patients with mineral and bone disorder |
| title_fullStr | Prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre-dialysis chronic kidney disease patients with mineral and bone disorder |
| title_full_unstemmed | Prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre-dialysis chronic kidney disease patients with mineral and bone disorder |
| title_short | Prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre-dialysis chronic kidney disease patients with mineral and bone disorder |
| title_sort | prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre dialysis chronic kidney disease patients with mineral and bone disorder |
| topic | chronic kidney disease clinical outcomes hypercalcaemia hypocalcaemia |
| url | https://journals.lww.com/10.4103/singaporemedj.SMJ-2021-391 |
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