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Outcomes associated with serum calcium level in men with non-dialysis-dependent chronic kidney disease

Csaba P Kovesdy1, Olga Kuchmak, Jun L Lu

  • 1Division of Nephrology, Salem VA Medical Center, 1970 Roanoke Boulevard, Salem, VA 24153, USA. csaba.kovesdy@va.gov

Clinical Journal of the American Society of Nephrology : CJASN
|January 9, 2010
PubMed

Insights

In non-dialysis-dependent chronic kidney disease (CKD), higher serum calcium correlates with long-term mortality, while lower calcium levels indicate increased short-term mortality risk.

Area of Science:

  • Nephrology
  • Cardiovascular Health
  • Mineral Metabolism

Background:

  • Elevated serum calcium is linked to higher mortality in dialysis patients.
  • The impact of serum calcium on mortality in non-dialysis-dependent chronic kidney disease (NDD CKD) is not well understood.
  • Outcomes associated with low serum calcium in NDD CKD require further characterization.

Purpose of the Study:

  • To investigate the association between serum calcium levels and all-cause mortality in patients with NDD CKD.
  • To differentiate the effects of baseline, time-varying, and time-averaged serum calcium on mortality.
  • To characterize outcomes related to both high and low serum calcium in this patient population.

Main Methods:

  • A historic prospective cohort study included 1243 men with moderate to advanced NDD CKD.
  • Cox proportional hazards models were utilized to analyze the associations.
  • Baseline, time-varying, and time-averaged serum calcium levels were examined in relation to all-cause mortality.

Main Results:

  • The relationship between serum calcium and mortality differed based on statistical modeling.
  • Higher baseline and time-averaged serum calcium were associated with increased long-term mortality.
  • Time-varying analyses revealed that lower serum calcium levels were linked to higher short-term mortality.

Conclusions:

  • Serum calcium levels have a dual association with mortality in NDD CKD patients: high levels for long-term, low levels for short-term.
  • These findings highlight the complex role of calcium in NDD CKD outcomes.
  • Further clinical trials are recommended to determine if normalizing serum calcium improves patient outcomes.
Abstract

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