ニッタ　コウサク   NITTA Kousaku   新田　孝作    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Patient characteristics modify the association between changes in mineral metabolism parameters and mortality in a nationwide hemodialysis cohort study.
掲載誌名	正式名：Scientific reports 略　 称：Sci Rep ISSNコード：20452322/20452322
巻・号・頁	15(1),pp.8089
著者・共著者	Goto Shunsuke, Hamano Takayuki, Taniguchi Masatomo, Abe Masanori, Nitta Kosaku, Nishi Shinichi, Fujii Hideki
発行年月	2025/03
概要	In hemodialysis patients, it remains unclear whether patient characteristics influence the clinical impacts of changes in serum mineral metabolism parameters on mortality. In this 9-year cohort study, we investigated the associations between the changes in calcium/phosphate levels and all-cause mortality using a time-dependent approach after adjustment for potential confounders in groups stratified by performance status (PS), a history of atherosclerotic cardiovascular disease (ACVD), or diabetic nephropathy (DN). In patients with baseline serum calcium levels of 9.5-<10.0 mg/dL, increases in serum calcium levels were associated with higher mortality exclusively in patients with PS Grade 0. In the same baseline calcium range, a significant association was observed between reduced serum calcium levels and lower mortality only in patients with a history of ACVD or DN. Similarly, in patients with baseline serum phosphate levels of 5.0-<5.5 mg/dL, reduced serum phosphate levels were associated with lower mortality only in those with PS Grade 0, a history of ACVD or DN. These findings indicate that PS should be considered in treating mild hypercalcemia or hyperphosphatemia in hemodialysis patients. Moreover, stringent management of hypercalcemia and hyperphosphatemia in patients with a history of ACVD or DN might be associated with a better prognosis.
DOI	10.1038/s41598-025-92359-0
PMID	40057535