Li Jialin, He Danni, Zhao Wenjing, Wu Xi'ai, Luo Minjing, Wang Ying, Yan Meihua, Niu Wenquan, Li Ping
Beijing Key Lab Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Science, China-Japan Friendship Hospital, Beijing, China.
Department of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Clin Exp Nephrol. 2021 Jul;25(7):760-770. doi: 10.1007/s10157-021-02037-4. Epub 2021 Mar 16.
We aimed to examine the association of three mineral metabolism markers, including serum calcium, inorganic phosphorus, and intact parathyroid hormone with the risk of chronic kidney disease (CKD) at all stages.
This retrospective cohort study involved 3563 participants, including 3274 CKD patients and 289 healthy controls. CKD is diagnosed according to clinical guidelines from the 2012 KDIGO. Effect sizes are expressed odds ratio (OR) and 95 confidence interval (CI).
After propensity score matching, per 0.5 mg/dL increment of inorganic phosphorus was significantly associated with 1.33-, 1.61-, and 2.85-fold increased risk of CKD at stages 1-2, 4, and 5, respectively. Regarding per 8 pg/mL increment of intact parathyroid hormone, significance was only noted for stage 5. In subsidiary analyses, the risk prediction of mineral metabolism markers under study was more evident in males and hypertensive subjects. A nomogram prediction model was constructed based on age, sex, and three mineral metabolism markers for CKD, with decent accuracy.
Our findings indicate that serum calcium was associated with all-stage CKD risk, whereas the association for inorganic phosphorus and intact parathyroid hormone was significant at advanced stages.
我们旨在研究三种矿物质代谢标志物，即血清钙、无机磷和全段甲状旁腺激素与各阶段慢性肾脏病（CKD）风险之间的关联。
这项回顾性队列研究纳入了3563名参与者，其中包括3274例CKD患者和289名健康对照者。CKD根据2012年改善全球肾脏病预后组织（KDIGO）的临床指南进行诊断。效应大小以比值比（OR）和95%置信区间（CI）表示。
倾向评分匹配后，无机磷每增加0.5mg/dL，分别与1-2期、4期和5期CKD风险增加1.33倍、1.61倍和2.85倍显著相关。全段甲状旁腺激素每增加8pg/mL，仅在5期有显著意义。在辅助分析中，所研究的矿物质代谢标志物的风险预测在男性和高血压患者中更为明显。基于年龄、性别和三种矿物质代谢标志物构建了CKD的列线图预测模型，准确性良好。
我们的研究结果表明，血清钙与各阶段CKD风险相关，而无机磷和全段甲状旁腺激素在晚期阶段的关联显著。
