Article Figures & Data
Figures
- Figure 1.
Cardiovascular (CV) events. Adjusted hazards ratios (AHR) for combinations of low and high levels of calcium, phosphorus, and parathyroid hormone (PTH). Adjustment has been made for the characteristics shown in Table 1. Reference category: Patients with phosphorus ≤5.5 mg/dl, calcium ≤10.2 mg/dl, and PTH ≤408 pg/ml. Error bars represent 95% confidence intervals.
- Figure 2.
Death. AHR for combinations of low and high levels of calcium, phosphorus, and PTH. Adjustment has been made for the characteristics shown in Table 1. Reference category: Patients with phosphorus ≤5.5 mg/dl, calcium ≤10.2 mg/dl, and PTH ≤408 pg/ml. Error bars represent 95% confidence intervals.
Tables
Characteristic % of Study Population Age (yr) <45 19.2 45 to 64 36.5 ≥65 44.3 Gender male 51.9 female 48.1 Race white 50.9 black 39.0 other 10.1 Former or current smoker 32.3 Cause of ESRD diabetes 32.5 hypertension 30.0 glomerulonephritis 13.7 other 23.8 Duration of ESRD (yr) <1.0 30.5 1.0 to 4.9 49.5 5.0 to 9.9 13.7 ≥10.0 6.3 Previous renal transplantation 7.1 Body mass index (kg/m2) <18.5 5.8 18.5 to 24.9 43.7 25.0 to 29.9 23.9 ≥30.0 16.7 missing 9.9 Kt/V <1.0 18.7 1.0 to 1.1 23.1 1.2 to 1.3 19.2 ≥1.4 15.1 missing 23.9 Albumin (g/dl) ≤3.4 20.1 3.5 to 3.7 21.9 3.8 to 3.9 18.4 4.0 to 4.1 14.4 >4.1 14.7 missing 10.5 Hemoglobin (g/dl) ≤8.8 19.3 8.9 to 9.7 19.3 9.8 to 10.4 18.0 10.5 to 11.2 17.5 >11.2 17.5 missing 8.4 Calcium (mg/dl) ≤8.7 18.5 8.8 to 9.2 18.1 9.3 to 9.6 18.1 9.7 to 10.2 18.1 >10.2 17.8 missing 9.4 Phosphorus (mg/dl) ≤4.4 19.7 4.5 to 5.3 17.2 5.4 to 6.3 18.7 6.4 to 7.5 16.9 >7.5 18.0 missing 9.5 Calcium × phosphorus product (mg2/dl2) ≤40.9 18.0 41.0–50.1 18.0 50.2–59.2 18.0 59.3–71.0 18.0 > 71.0 18.0 missing 10.0 Parathyroid hormone (pg/dl) ≤37 13.1 38 to 99 12.7 100 to 210 12.7 211 to 480 12.8 >480 12.8 missing 35.9 Comorbid conditions diabetes mellitus 40.7 coronary artery diseasea 36.7 congestive heart failure 39.7 stroke or transient ischemic attack 16.3 peripheral vascular disease 24.5 malignancy 9.4 chronic lung disease 12.5 ↵a History of coronary artery disease included one of the following: Angina, coronary artery disease, abnormal angiogram, angioplasty, coronary artery bypass grafting, and myocardial infarction.
- Table 2.
Hazards ratiosa (and 95% confidence intervals) for cardiovascular events and death
Cardiovascular Eventb(11,272/14,598c; 77.2%) Death(11,730/14,829; 79.1%) Calcium quintiles (mg/dl) ≤8.7 1.00 1.00 8.8 to 9.2 1.03 (0.97 to 1.09) 1.07 (1.01 to 1.14)d 9.3 to 9.6 1.04 (0.97 to 1.10) 1.05 (0.99 to 1.12) 9.7 to 10.2 1.03 (0.97 to 1.10) 1.11 (1.04 to 1.18)d >10.2 1.08 (1.01 to 1.15)d 1.14 (1.07 to 1.21)e missing 1.17 (0.93 to 1.47) 1.03 (0.83 to 1.29) Phosphorus quintiles (mg/dl) ≤4.4 1.00 1.00 4.5 to 5.3 1.06 (1.00 to 1.13)d 1.02 (0.96 to 1.09) 5.4 to 6.3 1.13 (1.06 to 1.19)e 1.02 (0.96 to 1.08) 6.4 to 7.5 1.14 (1.07 to 1.22)e 1.10 (1.04 to 1.17)d >7.5 1.25 (1.17 to 1.33)e 1.19 (1.12 to 1.27)e missing 1.13 (0.90 to 1.41) 1.19 (0.96 to 1.47) Calcium × phosphorus product (mg2/dl2) ≤40.9 1.00 1.00 41.0 to 50.1 1.04 (0.98 to 1.11) 0.99 (0.94 to 1.06) 50.2 to 59.2 1.09 (1.03 to 1.16)d 1.05 (0.99 to 1.12) 59.3 to 71.0 1.14 (1.07 to 1.22)e 1.09 (1.03 to 1.16)d >71.0 1.24 (1.16 to 1.32)e 1.19 (1.12 to 1.27)e missing 1.23 (1.08 to 1.39)d 1.12 (0.99 to 1.26) Parathyroid hormone (pg/dl) ≤37 1.00 1.00 38 to 99 1.03 (0.96 to 1.11) 1.06 (0.99 to 1.14) 100 to 210 1.04 (0.97 to 1.12) 1.07 (0.99 to 1.15) 211 to 480 1.04 (0.96 to 1.13) 1.07 (0.99 to 1.15) >480 1.12 (1.04 to 1.21)d 1.17 (1.08 to 1.26)e missing 1.06 (0.99 to 1.13) 1.12 (1.06 to 1.19)e ↵a Using Cox regression with all of the characteristics shown in the first column of Table 1 entered simultaneously, with the exception of calcium-phosphorus product. Hazards ratios for calcium-phosphorus product were adjusted for all variables except calcium and phosphorus.
↵b Hospitalization for ischemic heart disease, congestive heart failure, stroke, transient ischemic attack, or peripheral vascular disease, or cause of death on the ESRD Death Notification Form attributed to cardiac causes, cerebrovascular accident, or ischemic brain damage.
↵c Denominator <14,829 reflects negative follow-up intervals.
↵d P < 0.05.
↵e P < 0.0001.
Calcium, Phosphorus, Parathyroid Hormone, and Cardiovascular Disease in Hemodialysis Patients: The USRDS Waves 1, 3, and 4 Study
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