ArticleRenal failure2025
U-shaped association between serum calcium and all-cause mortality in coronary heart disease with chronic kidney disease: evidence from two cohort studies in China and the United States.
Article in Renal failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChronic kidney disease (CKD), as a major risk factor for coronary heart disease (CHD), had a large fluctuation of serum calcium in clinical research. Our study aims to identify the association between serum calcium and all-cause mortality in CHD patients with CKD.
methodsA retrospective cohort study was conducted, involving 2,286 participants from the CHD sub-cohort from the Eastern Guangdong Health and Disease Cohort Platform (EGHDCP) and 1,278 participants from National Health and Nutrition Examination Survey (NHANES) database. Cox proportional hazards regression models, stratified analysis with interaction, restricted cubic splines (RCS), and threshold effect analysis were applied to investigate the association between serum calcium and all-cause mortality of CHD with CKD.
resultsThe association between serum calcium and all-cause mortality of CHD patients with CKD from EGHDCP-CHD exhibited an U-shaped curve in RCS, which was similar to be observed in NHANES cohort. In EGHDCP-CHD cohort, Cox regression models demonstrated that subjects in the lowest or the highest serum calcium group had a significantly higher risk of mortality. Besides, both cohorts showed similar inflection points in the threshold analysis. In EGHDCP-CHD cohort, the risk of all-cause mortality reduced by 9.73% with every 0.1 mmol/L increased in serum calcium (Hazard ratio (HR) = 0.027, 95% confidence interval (CI): 0.005-0.145,
conclusionThere was an U-shaped connection between serum calcium and all-cause mortality in CHD patients with CKD.
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