Related Experiment Video

Updated: Sep 2, 2025

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
05:34

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

Published on: April 4, 2025

800

Mineral and bone disorder and longterm survival in a chronic kidney disease grade 3b-4cohort

Pablo Rios1, Ricardo Silvariño1,2, Laura Sola1

  • 1Comisión Asesora Programa de Salud Renal, Fondo Nacional de Recursos, Montevideo, Uruguay.

Renal Failure
|August 10, 2022
PubMed

Insights

Mineral and bone disorder biomarkers impact mortality in chronic kidney disease (CKD) G3b-4 patients. Higher phosphate, iPTH, and lower vitamin D levels increase mortality risk, while vitamin D treatment reduces it.

Area of Science:

  • Nephrology
  • Endocrinology
  • Clinical Biochemistry

Background:

  • Mineral and bone disorder (MBD) biomarker reference ranges in chronic kidney disease (CKD) are debated.
  • CKD patients experience high mortality rates, often linked to MBD.
  • Accurate MBD biomarker levels are crucial for predicting mortality risk in CKD.

Purpose of the Study:

  • To investigate the association between serum calcium (Ca), phosphate (P), intact parathyroid hormone (iPTH), and 25(OH) vitamin D levels and mortality risk.
  • To evaluate these associations in a cohort of CKD G3b-4 patients.
  • To inform precise MBD biomarker level definitions for CKD G3b-4.

Main Methods:

  • Analysis of a large CKD cohort (n=6473) from the Uruguayan National Renal Healthcare Program (NRHP-UY).
  • Inclusion period: October 2004 - March 2020, follow-up until March 2021.
  • Bivariate and multivariate Cox regression analyses adjusted for multiple clinical factors were performed.

Main Results:

  • Higher mortality risk was significantly associated with serum phosphate > 4.00 mg/dl (HR 1.668), iPTH > 105 pg/ml (HR 1.386), and 25(OH) vitamin D ≤ 10 ng/ml (HR 1.958).
  • Lower mortality risk was observed with 1,25(OH)2 vitamin D treatment (HR 0.639).
  • Bivariate analysis indicated optimal ranges for reduced mortality: Ca 9.01-10.25 mg/dl, P 2.76-4.0 mg/dl, iPTH ≤ 105 pg/ml, and 25(OH) vitamin D > 10 ng/ml.

Conclusions:

  • Serum phosphate, iPTH, and 25(OH) vitamin D levels are significant predictors of mortality in CKD G3b-4 patients.
  • Maintaining optimal levels of these biomarkers and considering vitamin D treatment may reduce mortality risk.
  • These findings support refining target ranges for MBD biomarkers in CKD management.

Keywords:
Calciumchronic kidney disease 3b-4mineral metabolismparathyroid hormonephosphatesurvival analysis

More Related Videos

Murine Hind Limb Long Bone Dissection and Bone Marrow Isolation07:17

Murine Hind Limb Long Bone Dissection and Bone Marrow Isolation

Published on: April 14, 2016

84.6K
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro11:30

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

Published on: June 2, 2022

2.1K

Related Concept Videos

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...
76
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...
74
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
75
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
50
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...
60
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...
55