BACKGROUND AND OBJECTIVES: Serum alkaline phosphatase has been associated with increased mortality in hemodialysis patients but its associations with mortality in chronic kidney disease (CKD) stages III and IV are unknown. Design, settings, participants & measurements: In 1094 participants in the African-American Study of Kidney Disease and Hypertension (AASK) database, the associations of serum alkaline phosphatase with mortality and cardiovascular events were examined in Cox models. RESULTS: The mean (+/-SD) age was 54 +/- 11 yr, and 61% were men. The median alkaline phosphatase was 80 IU/L, and interquartile range was 66 to 97 IU/L. The mean follow-up was 4.6 yr. There were 105 (9.6%) all-cause deaths and 149 (13.6%) cardiovascular events. Each doubling of serum alkaline phosphatase was significantly associated with increased hazard [hazard ratio (HR) 1.60, 95% confidence interval (CI) 1.08 -2.36] of all-cause mortality adjusted for demographics, drug and blood pressure groups, and comorbidity. With further adjustment for liver function tests as well as serum calcium and phosphorus, each doubling of serum alkaline phosphatase remained significantly associated with increased mortality (HR 1.55, 95% CI 1.03 to 2.33). Serum alkaline phosphatase was not significantly associated with increased risk of cardiovascular events. CONCLUSIONS: Independent of liver function tests and serum calcium and phosphorus, higher levels of serum alkaline phosphatase are associated with increased mortality in the CKD population. Further studies are warranted to identify the potential mechanisms for this association.
BACKGROUND AND OBJECTIVES: Serum alkaline phosphatase has been associated with increased mortality in hemodialysis patients but its associations with mortality in chronic kidney disease (CKD) stages III and IV are unknown. Design, settings, participants & measurements: In 1094 participants in the African-American Study of Kidney Disease and Hypertension (AASK) database, the associations of serum alkaline phosphatase with mortality and cardiovascular events were examined in Cox models. RESULTS: The mean (+/-SD) age was 54 +/- 11 yr, and 61% were men. The median alkaline phosphatase was 80 IU/L, and interquartile range was 66 to 97 IU/L. The mean follow-up was 4.6 yr. There were 105 (9.6%) all-cause deaths and 149 (13.6%) cardiovascular events. Each doubling of serum alkaline phosphatase was significantly associated with increased hazard [hazard ratio (HR) 1.60, 95% confidence interval (CI) 1.08 -2.36] of all-cause mortality adjusted for demographics, drug and blood pressure groups, and comorbidity. With further adjustment for liver function tests as well as serum calcium and phosphorus, each doubling of serum alkaline phosphatase remained significantly associated with increased mortality (HR 1.55, 95% CI 1.03 to 2.33). Serum alkaline phosphatase was not significantly associated with increased risk of cardiovascular events. CONCLUSIONS: Independent of liver function tests and serum calcium and phosphorus, higher levels of serum alkaline phosphatase are associated with increased mortality in the CKD population. Further studies are warranted to identify the potential mechanisms for this association.
Authors: Margaret J Blayney; Ronald L Pisoni; Jennifer L Bragg-Gresham; Juergen Bommer; Luis Piera; Akira Saito; Takashi Akiba; Marcia L Keen; Eric W Young; Friedrich K Port Journal: Kidney Int Date: 2008-06-11 Impact factor: 10.612
Authors: Jackson T Wright; George Bakris; Tom Greene; Larry Y Agodoa; Lawrence J Appel; Jeanne Charleston; DeAnna Cheek; Janice G Douglas-Baltimore; Jennifer Gassman; Richard Glassock; Lee Hebert; Kenneth Jamerson; Julia Lewis; Robert A Phillips; Robert D Toto; John P Middleton; Stephen G Rostand Journal: JAMA Date: 2002-11-20 Impact factor: 56.272
Authors: L Y Agodoa; L Appel; G L Bakris; G Beck; J Bourgoignie; J P Briggs; J Charleston; D Cheek; W Cleveland; J G Douglas; M Douglas; D Dowie; M Faulkner; A Gabriel; J Gassman; T Greene; Y Hall; L Hebert; L Hiremath; K Jamerson; C J Johnson; J Kopple; J Kusek; J Lash; J Lea; J B Lewis; M Lipkowitz; S Massry; J Middleton; E R Miller; K Norris; D O'Connor; A Ojo; R A Phillips; V Pogue; M Rahman; O S Randall; S Rostand; G Schulman; W Smith; D Thornley-Brown; C C Tisher; R D Toto; J T Wright; S Xu Journal: JAMA Date: 2001-06-06 Impact factor: 56.272
Authors: Bernard M Y Cheung; Kwok Leung Ong; Roberta V Cheung; Louisa Y F Wong; Nelson M S Wat; Sidney Tam; Gabriel M Leung; Chun Ho Cheng; Jean Woo; Edward D Janus; Chu Pak Lau; Tai Hing Lam; Karen S L Lam Journal: Clin Chem Lab Med Date: 2008 Impact factor: 3.694
Authors: Sonoko Narisawa; Dympna Harmey; Manisha C Yadav; W Charles O'Neill; Marc F Hoylaerts; Jose Luis Millán Journal: J Bone Miner Res Date: 2007-11 Impact factor: 6.741
Authors: Rebecca Filipowicz; Tom Greene; Guo Wei; Alfred K Cheung; Kalani L Raphael; Bradley C Baird; Srinivasan Beddhu Journal: Clin J Am Soc Nephrol Date: 2012-11-02 Impact factor: 8.237