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Mineral Metabolic Abnormalities and Mortality in Dialysis Patients
Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1, Oyaguchi Kami-chou, Itabashi-ku, Tokyo 173-8610, Japan
Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, 30-1, Oyaguchi Kami-chou, Itabashi-ku, Tokyo 173-8610, Japan
* Author to whom correspondence should be addressed.
Received: 10 January 2013; in revised form: 19 February 2013 / Accepted: 7 March 2013 / Published: 22 March 2013
Abstract: The survival rate of dialysis patients, as determined by risk factors such as hypertension, nutritional status, and chronic inflammation, is lower than that of the general population. In addition, disorders of bone mineral metabolism are independently related to mortality and morbidity associated with cardiovascular disease and fracture in dialysis patients. Hyperphosphatemia is an important risk factor of, not only secondary hyperparathyroidism, but also cardiovascular disease. On the other hand, the risk of death reportedly increases with an increase in adjusted serum calcium level, while calcium levels below the recommended target are not associated with a worsened outcome. Thus, the significance of target levels of serum calcium in dialysis patients is debatable. The consensus on determining optimal parathyroid function in dialysis patients, however, is yet to be established. Therefore, the contribution of phosphorus and calcium levels to prognosis is perhaps more significant. Elevated fibroblast growth factor 23 levels have also been shown to be associated with cardiovascular events and death. In this review, we examine the associations between mineral metabolic abnormalities including serum phosphorus, calcium, and parathyroid hormone and mortality in dialysis patients.
Keywords: calcium; chronic kidney disease; phosphate; mineral and bone disorder; vascular calcification
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MDPI and ACS Style
Abe, M.; Okada, K.; Soma, M. Mineral Metabolic Abnormalities and Mortality in Dialysis Patients. Nutrients 2013, 5, 1002-1023.
Abe M, Okada K, Soma M. Mineral Metabolic Abnormalities and Mortality in Dialysis Patients. Nutrients. 2013; 5(3):1002-1023.
Abe, Masanori; Okada, Kazuyoshi; Soma, Masayoshi. 2013. "Mineral Metabolic Abnormalities and Mortality in Dialysis Patients." Nutrients 5, no. 3: 1002-1023.