�Among patients receiving dialysis for inveterate kidney disease (CKD), high levels of alkaline phosphatase a routinely measured testing ground marker of bone disease may signal an increased risk of death, reports a study in the November Journal of the American Society of Nephrology (JASN).
"This large epidemiologic study shows, for the number one time, a consistent and robust connexion between a high blood level of alkaline phosphatase and cardiovascular death in thousands of dialysis patients across the United States," comments Kamyar Kalantar-Zadeh, MD, of the University of California Los Angeles, one of the study authors. "If the association between alkaline phosphatase and death rate has a causal connectedness, treatment strategies that reduce alkaline phosphatase levels may improve survival in patients with CKD, and in all likelihood in many other patients with chronic diseases and active bone disorders."
The researchers analyzed data on virtually 74,000 hemodialysis patients in DaVita dialysis clinics during a three-year period. Laboratory measurements of alkaline phosphatase level measured in a DaVita laboratory nub were analyzed as a possible predictor of deathrate risk. In dialysis patients, alkaline phosphatase levels are routinely mensurable to monitor metabolic osseous tissue disease, a common knottiness of CKD. However, stream guidelines do not include specific recommendations or targets for serum alkaline phosphatase in CKD patients.
The results showed that patients with higher alkalic phosphatase levels were at higher hazard of decease during the three-year followup period. After adjustment for a wide range of other hazard factors, patients with alkaline phosphatase levels above the upper limit of normal (>120 IU/L) had a 25 percent increase in mortality rate.
The link between alkaline phosphatase and deathrate was significant across versatile subgroups of dialysis patients. Surprisingly, this included patients without hepatitis or
