Related Experiment Video

Updated: Jun 20, 2026

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
11:30

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro

Published on: June 2, 2022

Serum alkaline phosphatase and mortality in African Americans with chronic kidney disease

Srinivasan Beddhu1, Xiulian Ma, Bradley Baird

  • 1Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA. Srinivasan.beddhu@hsc.utah.edu

Clinical Journal of the American Society of Nephrology : CJASN
|September 5, 2009
PubMed

Insights

Higher serum alkaline phosphatase levels are linked to increased mortality in chronic kidney disease (CKD) patients. This association persists even after accounting for liver function and mineral levels, suggesting a significant risk factor for CKD mortality.

Area of Science:

  • Nephrology
  • Biochemistry

Background:

  • Serum alkaline phosphatase (sALP) is linked to mortality in hemodialysis patients.
  • Associations between sALP and mortality in earlier stages of chronic kidney disease (CKD) are not well-established.

Purpose of the Study:

  • To investigate the association between serum alkaline phosphatase levels and mortality in patients with CKD stages III and IV.
  • To examine the relationship between sALP and cardiovascular events in this population.

Main Methods:

  • Analysis of data from 1094 participants in the African-American Study of Kidney Disease and Hypertension (AASK) database.
  • Cox proportional hazards models were used to assess associations with all-cause mortality and cardiovascular events.
  • Adjustments were made for demographics, treatment groups, comorbidities, liver function tests, and serum calcium and phosphorus levels.

Main Results:

  • Each doubling of sALP was significantly associated with a 60% increased hazard of all-cause mortality (HR 1.60, 95% CI 1.08-2.36) after demographic and comorbidity adjustments.
  • This association remained significant after further adjustment for liver function and mineral levels (HR 1.55, 95% CI 1.03-2.33).
  • sALP was not significantly associated with an increased risk of cardiovascular events.

Conclusions:

  • Elevated serum alkaline phosphatase levels are independently associated with increased all-cause mortality in patients with CKD stages III and IV.
  • The findings suggest sALP may be a valuable biomarker for mortality risk in CKD.
  • Further research is needed to elucidate the underlying mechanisms driving this association.
Abstract

More Related Videos

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats05:34

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats

Published on: April 4, 2025

Related Concept Videos

Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
Serum Studies: Renal Function Tests01:24

Serum Studies: Renal Function Tests

Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...