Outcomes Associated with Serum Calcium Level in Men with Non-dialysis-dependent Chronic Kidney Disease

Overview

Journal Clin J Am Soc Nephrol

Specialty Nephrology

Date 2010 Jan 9

PMID 20056754

Citations 28

Authors

Csaba P Kovesdy

Olga Kuchmak

Jun L Lu

Kamyar Kalantar-Zadeh

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Elevated serum calcium has been associated with increased mortality in dialysis patients, but it is unclear whether the same is true in non-dialysis-dependent (NDD) chronic kidney disease (CKD). Outcomes associated with low serum calcium are also not well-characterized.

Design, Setting, Participants, & Measurements: We examined associations of baseline, time-varying, and time-averaged serum calcium with all-cause mortality in a historic prospective cohort of 1243 men with moderate and advanced NDD CKD by using Cox models.

Results: The association of serum calcium with mortality varied according to the applied statistical models. Higher baseline calcium and time-averaged calcium were associated with higher mortality (multivariable adjusted hazard ratio (95% confidence interval): 1.31 (1.13, 1.53); P < 0.001 for a baseline calcium 1 mg/dl higher). However, in time-varying analyses, lower calcium levels were associated with increased mortality.

Conclusions: Higher serum calcium is associated with increased long-term mortality (as reflected by the baseline and time-averaged models), and lower serum calcium is associated with increased short-term mortality (as reflected by the time-varying models) in patients with NDD CKD. Clinical trials are warranted to determine whether maintaining normal serum calcium can improve outcomes in these patients.

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