Increased Risk of Infection-Related and All-Cause Death in Hypercalcemic Patients Receiving Hemodialysis: The Q-Cohort Study

Sci Rep. 2020 Apr 14;10(1):6327. doi: 10.1038/s41598-020-63334-8.

Abstract

Although hypercalcemia is a risk factor for all-cause mortality in hemodialysis patients, it remains unknown whether hypercalcemia increases the risk of infection-related death. A total of 2869 hemodialysis patients registered in the Q-Cohort Study, a multicenter, prospective cohort study of hemodialysis patients, were analyzed. The predictor was albumin-corrected serum calcium level at baseline. The main outcome was infection-related death. Death risk were estimated by multivariable-adjusted Cox proportional hazard risk models and competing risk models. During the follow-up period of 4 years, 107 patients died of infection and 473 died of any cause. The patients were divided into four groups by the serum calcium level at baseline (G1, 5.7-8.9 mg/dL; G2, 9.0-9.4 mg/dL; G3, 9.5-9.9 mg/L; G4 10.0-16.5 mg/dL). In the multivariable-adjusted model, the incidence of infection-related death was significantly higher in the highest serum calcium group (G4) compared with the lowest serum calcium group (G1): hazard ratio [95% confidence interval], 2.34 [1.35-4.04], P = 0.002. Furthermore, higher serum calcium level was significantly associated with increased risk of all-cause death. In conclusion, our data suggest that a higher serum calcium level may be a risk factor for infection-related and all-cause death in hemodialysis patients.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Calcium / blood
  • Cause of Death*
  • Chronic Kidney Disease-Mineral and Bone Disorder / blood
  • Chronic Kidney Disease-Mineral and Bone Disorder / complications
  • Chronic Kidney Disease-Mineral and Bone Disorder / mortality*
  • Chronic Kidney Disease-Mineral and Bone Disorder / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Hypercalcemia / blood
  • Hypercalcemia / etiology
  • Hypercalcemia / mortality*
  • Hypercalcemia / therapy
  • Infections / mortality*
  • Japan / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • Renal Dialysis / adverse effects*
  • Risk Assessment / statistics & numerical data
  • Risk Factors

Substances

  • Calcium