Dialysis Risks

(Ivanhoe Newswire) -- A simple bone disease test may signal an increased risk of death for people on dialysis for chronic kidney disease.

That’s the key finding from UCLA researchers who looked at alkaline phosphatase levels in nearly 74,000 patients over a three-year period. After adjustment for other factors that could influence mortality, the investigators found higher levels of the marker increased the death rate by 25 percent.

Doctors routinely track alkaline phosphatase levels in dialysis patients because bone disease is a common complication in people with chronic kidney disease (CKD). “In dialysis patients, increased levels of alkaline phosphatase in the blood indicate a so-called high-turnover bone disease, which can happen due to hormonal imbalance in CKD,” study author Kamyar Kalantar-Zadeh, M.D. was quoted as saying.

Recent studies linked alkaline phosphatase to increased vascular calcification – a hallmark of heart disease. “Our study shows the clinical manifestations of this association in real-world patients,” said Kalantar-Zadeh.

The researchers stop short of saying alkaline phosphatase levels are actually responsible for the higher mortality seen in this study, but believe the area deserves more study. “For the ultimate proof of causation, treatment trials are needed to target high bone turnover diseases to reduce serum alkaline phosphatase effectively, and then to ascertain whether these interventions can improve survival,” emphasizes Dr. Kalantar-Zadeh.

SOURCE: Journal of the American Society of Nephrology, published online July 30, 2008