ArticlePeritoneal dialysis international : journal of the International Society for Peritoneal Dialysis
Comparative mortality-predictability using alkaline phosphatase and parathyroid hormone in patients on peritoneal dialysis and hemodialysis.
Open access · greenAbstract readComparative Study
In one paragraph
Article in Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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33citing papers in PubMed, 2 pooled it
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Risk factors for mortality in patients undergoing peritoneal dialysis: a systematic review and meta-analysis.Renal failure · 2021Pooled it
- Elevated serum alkaline phosphatase and cardiovascular or all-cause mortality risk in dialysis patients: A meta-analysis.Scientific reports · 2017Pooled it
- Factors associated with vascular calcification in peritoneal dialysis patients: a meta-analysis.International urology and nephrology · 2026Article
- Association between serum intact parathyroid hormone and survival in dialysis patients.International urology and nephrology · 2025Article
- Machine learning for identification of short-term all-cause and cardiovascular deaths among patients undergoing peritoneal dialysis.Clinical kidney journal · 2024Article
- Serum alkaline phosphatase is a strong predictor of mortality in ESKD patients: analysis of the RISCAVID cohort.Journal of nephrology · 2024Observational
- Longitudinal study on the change trend of serum alkaline phosphatase and its possible influencing factors in peritoneal dialysis patients.Scientific reports · 2024Article
- Relationships between blood bone metabolic biomarkers and anemia in patients with chronic kidney disease.Renal failure · 2023Article
- Hungry bone syndrome in peritoneal dialysis patients after parathyroid surgery.Endocrine connections · 2023Article
- Associations between liver function parameters and poor clinical outcomes in peritoneal dialysis patients.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2023Review
- Relationship between serum iPTH and peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis.Frontiers in endocrinology · 2023Article
- Optimal targets of chronic kidney disease-mineral and bone disorder markers for Chinese patients with maintenance peritoneal dialysis: a single-center retrospective cohort study.Renal failure · 2022Article
- Article
- Alkaline Phosphatase: An Old Friend as Treatment Target for Cardiovascular and Mineral Bone Disorders in Chronic Kidney Disease.Nutrients · 2022Review
- Comparative Effectiveness of Dialysis Modality on Laboratory Parameters of Mineral Metabolism.American journal of nephrology · 2022Article
- From the Old, the Best: Parathyroidectomy in the Management of Soft-Tissue and Vascular Calcification in Patients with Chronic Renal Disease.Case reports in nephrology · 2021Article
- Liver Function Enzymes are Potential Predictive Markers for Kidney Allograft Dysfunction.Advancements in journal of urology and nephrology · 2020Article
- Serum level vitamin D and parathyroid hormone, and mortality, with or without chronic kidney disease.Journal of bone and mineral metabolism · 2019Article
- Age differences in associations of serum alkaline phosphatase and mortality among peritoneal dialysis patients.Chinese medical journal · 2019Article
- Stabilization of serum alkaline phosphatase in hemodialysis patients by implementation of local chronic kidney disease-mineral bone disorder management strategy: A quality improvement study.Kidney research and clinical practice · 2018Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Connie M RheeHarold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Cen
Miklos Z MolnarHarold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Cen
Wei Ling LauHarold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA.
Vanessa RavelHarold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA.
Csaba P KovesdyHarold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA.
Rajnish MehrotraHarold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA.
Kamyar Kalantar-ZadehHarold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Center, and Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA; Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA Harold Simmons Center for Kidney Disease Research and Epidemiology, University of California-Irvine, Orange, California; Division of Nephrology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Nephrology and Hypertension, University of California-Irvine, Irvine, California, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Memphis Veterans Affairs Medical Cen
University of California, Irvine Medical Center · USUniversity Health Network · CAUniversity of California, Irvine · USUniversity of Tennessee Health Science Center · USUniversity of Washington · US
Funding
TRAINING PROGRAM IN ACADEMIC NEPHROLOGYT32DK007527 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI BONVENTRE, JOSEPH VINCENT · 1986 to 2021
$8.8MUnderstanding Sources of Bias and Outcomes in Peritoneal Dialysis Patient ResearcR21DK077341 · NIDDK · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI KALANTAR-ZADEH, KAMYAR · 2009 to 2010
$409kRisk Factors and Sequelae of Thyroid Disease in Patients with Renal DysfunctionF32DK093201 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI RHEE, CONNIE MEEYOUNG · 2012 to 2012
$65kNIDDK NIH HHS F32 DK093201NIDDK NIH HHS R21 DK077341NIDDK NIH HHS T32 DK007527
Abstract
backgroundIn hemodialysis (HD) patients, serum alkaline phosphatase (ALP) and parathyroid hormone (PTH) derangements are associated with mortality, but outcome-predictability using ALP and PTH in peritoneal dialysis (PD) patients remains uncertain.
methodsIn a cohort of 9244 adult PD patients from a large national dialysis organization (entry period 2001 - 2006, with follow-up through 2009), we used multivariable Cox models adjusted for case-mix and laboratory covariates to examine the associations of time-averaged ALP and PTH with all-cause mortality. We then compared mortality-predictability using ALP and PTH in 9244 PD and 99 323 HD patients.
resultsIn PD patients, ALP concentrations exceeding 150 U/L were associated with increased mortality (reference ALP: 70 to <90 U/L). Hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.18 (1.03 to 1.36), 1.27 (1.08 to 1.50), 1.49 (1.23 to 1.79), and 1.35 (1.19 to 1.53) for ALP concentrations of 150 to <170 U/L, 170 to <190 U/L, 190 to <210 U/L, and ≥210 U/L respectively. In contrast, we observed a U-shaped association between PTH concentration and death risk in PD patients, with PTH concentrations of less than 200 pg/mL and 700 pg/mL or more associated with increased mortality (reference PTH: 200 to <300 pg/mL). Hazard ratios and 95% CIs were 1.25 (1.12 to 1.41), 1.12 (1.02 to 1.23), 1.06 (0.96 to 1.18), 1.09 (0.97 to 1.24), 1.12 (0.97 to 1.29), 1.18 (0.99 to 1.40), and 1.23 (1.09 to 1.38) for PTH concentrations of <100 pg/mL, 100 to <200 pg/mL, 300 to <400 pg/mL, 400 to <500 pg/mL, 500 to <600 pg/mL, 600 to <700 pg/mL, and ≥700 pg/mL respectively. Compared with PD patients having serum concentrations of ALP and PTH within reference ranges, patients on HD experienced increased mortality across all ALP and PTH concentrations, particularly those in the lowest and highest categories.
conclusionsIn summary, higher ALP concentrations are associated with increased mortality, and lower and higher PTH concentrations are both associated with death risk in PD patients. The utility of ALP in the management of chronic kidney disease mineral bone disorders in PD patients warrants further study.
Indexed as
AdultAgedAlkaline PhosphataseBiomarkersCause of DeathCohort StudiesDatabases, FactualFemaleFollow-Up StudiesHumansKidney Failure, ChronicMaleMiddle AgedMultivariate AnalysisParathyroid HormonePeritoneal DialysisAlkaline PhosphataseBiomarkersParathyroid Hormonealkaline phosphataseCKD mineral bone disordersparathyroid hormone
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