Serum Alkaline Phosphatase Levels Predict Infection-Related Mortality and Hospitalization in Peritoneal Dialysis Patients

Seun Deuk Hwang, Su Hyun Kim, Young Ok Kim, Dong Chan Jin, Ho Chul Song, Euy Jin Choi, Yong Lim Kim, Yon Su Kim, Shin-Wook Kang, Nam Ho Kim, Chul Woo Yang, Yong Kyun Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Serum alkaline phosphatase (ALP) levels have been reported to be associated with all-cause and cardiovascular mortality in peritoneal dialysis (PD) patients. However, it is unclear whether serum ALP levels predict infection-related clinical outcomes in PD patients. The aim of this study was to determine the relationships between serum ALP levels, infection-related mortality and hospitalization in PD patients.

METHODS: PD patients from the Clinical Research Center registry for end-stage renal disease, a multicenter prospective observational cohort study in Korea, were included in the present study. Patients were categorized into three groups by serum ALP tertiles as follows: Tertile 1, ALP <78 U/L; Tertile 2, ALP = 78-155 U/L; Tertile 3, ALP >155 U/L. Tertile 1 was used as the reference category. The primary outcomes were infection-related mortality and hospitalization.

RESULTS: A total of 1,455 PD patients were included. The median follow-up period was 32 months. The most common cause of infection-related mortality and hospitalization was PD-related peritonitis. Multivariate Cox regression analyses showed that patients in the highest tertiles of serum ALP levels were at higher risk of infection-related mortality (HR 2.29, 95% CI, 1.42-5.21, P = 0.008) after adjustment for clinical variables. Higher tertiles of serum ALP levels were associated with higher risk of infection-related hospitalization (Tertile 2: HR 1.56, 95% CI, 1.18-2.19, P = 0.009, tertile 3: HR 1.34, 95% CI, 1.03-2.62, P = 0.031).

CONCLUSIONS: Our data showed that elevated serum ALP levels were independently associated with a higher risk of infection-related mortality and hospitalization in PD patients.

Original languageEnglish
Pages (from-to)e0157361
JournalPloS one
Volume11
Issue number6
DOIs
Publication statusPublished - 2016 Jan 1

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Dialysis
Peritoneal Dialysis
dialysis
Alkaline Phosphatase
alkaline phosphatase
Hospitalization
Mortality
Infection
Serum
infection
peritonitis
Korea
kidney diseases
Peritonitis
cohort studies
Chronic Kidney Failure
Observational Studies
Korean Peninsula
Registries
Cohort Studies

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Hwang, S. D., Kim, S. H., Kim, Y. O., Jin, D. C., Song, H. C., Choi, E. J., ... Kim, Y. K. (2016). Serum Alkaline Phosphatase Levels Predict Infection-Related Mortality and Hospitalization in Peritoneal Dialysis Patients. PloS one, 11(6), e0157361. https://doi.org/10.1371/journal.pone.0157361
Hwang, Seun Deuk ; Kim, Su Hyun ; Kim, Young Ok ; Jin, Dong Chan ; Song, Ho Chul ; Choi, Euy Jin ; Kim, Yong Lim ; Kim, Yon Su ; Kang, Shin-Wook ; Kim, Nam Ho ; Yang, Chul Woo ; Kim, Yong Kyun. / Serum Alkaline Phosphatase Levels Predict Infection-Related Mortality and Hospitalization in Peritoneal Dialysis Patients. In: PloS one. 2016 ; Vol. 11, No. 6. pp. e0157361.
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title = "Serum Alkaline Phosphatase Levels Predict Infection-Related Mortality and Hospitalization in Peritoneal Dialysis Patients",
abstract = "BACKGROUND: Serum alkaline phosphatase (ALP) levels have been reported to be associated with all-cause and cardiovascular mortality in peritoneal dialysis (PD) patients. However, it is unclear whether serum ALP levels predict infection-related clinical outcomes in PD patients. The aim of this study was to determine the relationships between serum ALP levels, infection-related mortality and hospitalization in PD patients.METHODS: PD patients from the Clinical Research Center registry for end-stage renal disease, a multicenter prospective observational cohort study in Korea, were included in the present study. Patients were categorized into three groups by serum ALP tertiles as follows: Tertile 1, ALP <78 U/L; Tertile 2, ALP = 78-155 U/L; Tertile 3, ALP >155 U/L. Tertile 1 was used as the reference category. The primary outcomes were infection-related mortality and hospitalization.RESULTS: A total of 1,455 PD patients were included. The median follow-up period was 32 months. The most common cause of infection-related mortality and hospitalization was PD-related peritonitis. Multivariate Cox regression analyses showed that patients in the highest tertiles of serum ALP levels were at higher risk of infection-related mortality (HR 2.29, 95{\%} CI, 1.42-5.21, P = 0.008) after adjustment for clinical variables. Higher tertiles of serum ALP levels were associated with higher risk of infection-related hospitalization (Tertile 2: HR 1.56, 95{\%} CI, 1.18-2.19, P = 0.009, tertile 3: HR 1.34, 95{\%} CI, 1.03-2.62, P = 0.031).CONCLUSIONS: Our data showed that elevated serum ALP levels were independently associated with a higher risk of infection-related mortality and hospitalization in PD patients.",
author = "Hwang, {Seun Deuk} and Kim, {Su Hyun} and Kim, {Young Ok} and Jin, {Dong Chan} and Song, {Ho Chul} and Choi, {Euy Jin} and Kim, {Yong Lim} and Kim, {Yon Su} and Shin-Wook Kang and Kim, {Nam Ho} and Yang, {Chul Woo} and Kim, {Yong Kyun}",
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Hwang, SD, Kim, SH, Kim, YO, Jin, DC, Song, HC, Choi, EJ, Kim, YL, Kim, YS, Kang, S-W, Kim, NH, Yang, CW & Kim, YK 2016, 'Serum Alkaline Phosphatase Levels Predict Infection-Related Mortality and Hospitalization in Peritoneal Dialysis Patients', PloS one, vol. 11, no. 6, pp. e0157361. https://doi.org/10.1371/journal.pone.0157361

Serum Alkaline Phosphatase Levels Predict Infection-Related Mortality and Hospitalization in Peritoneal Dialysis Patients. / Hwang, Seun Deuk; Kim, Su Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong Lim; Kim, Yon Su; Kang, Shin-Wook; Kim, Nam Ho; Yang, Chul Woo; Kim, Yong Kyun.

In: PloS one, Vol. 11, No. 6, 01.01.2016, p. e0157361.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Serum Alkaline Phosphatase Levels Predict Infection-Related Mortality and Hospitalization in Peritoneal Dialysis Patients

AU - Hwang, Seun Deuk

AU - Kim, Su Hyun

AU - Kim, Young Ok

AU - Jin, Dong Chan

AU - Song, Ho Chul

AU - Choi, Euy Jin

AU - Kim, Yong Lim

AU - Kim, Yon Su

AU - Kang, Shin-Wook

AU - Kim, Nam Ho

AU - Yang, Chul Woo

AU - Kim, Yong Kyun

PY - 2016/1/1

Y1 - 2016/1/1

N2 - BACKGROUND: Serum alkaline phosphatase (ALP) levels have been reported to be associated with all-cause and cardiovascular mortality in peritoneal dialysis (PD) patients. However, it is unclear whether serum ALP levels predict infection-related clinical outcomes in PD patients. The aim of this study was to determine the relationships between serum ALP levels, infection-related mortality and hospitalization in PD patients.METHODS: PD patients from the Clinical Research Center registry for end-stage renal disease, a multicenter prospective observational cohort study in Korea, were included in the present study. Patients were categorized into three groups by serum ALP tertiles as follows: Tertile 1, ALP <78 U/L; Tertile 2, ALP = 78-155 U/L; Tertile 3, ALP >155 U/L. Tertile 1 was used as the reference category. The primary outcomes were infection-related mortality and hospitalization.RESULTS: A total of 1,455 PD patients were included. The median follow-up period was 32 months. The most common cause of infection-related mortality and hospitalization was PD-related peritonitis. Multivariate Cox regression analyses showed that patients in the highest tertiles of serum ALP levels were at higher risk of infection-related mortality (HR 2.29, 95% CI, 1.42-5.21, P = 0.008) after adjustment for clinical variables. Higher tertiles of serum ALP levels were associated with higher risk of infection-related hospitalization (Tertile 2: HR 1.56, 95% CI, 1.18-2.19, P = 0.009, tertile 3: HR 1.34, 95% CI, 1.03-2.62, P = 0.031).CONCLUSIONS: Our data showed that elevated serum ALP levels were independently associated with a higher risk of infection-related mortality and hospitalization in PD patients.

AB - BACKGROUND: Serum alkaline phosphatase (ALP) levels have been reported to be associated with all-cause and cardiovascular mortality in peritoneal dialysis (PD) patients. However, it is unclear whether serum ALP levels predict infection-related clinical outcomes in PD patients. The aim of this study was to determine the relationships between serum ALP levels, infection-related mortality and hospitalization in PD patients.METHODS: PD patients from the Clinical Research Center registry for end-stage renal disease, a multicenter prospective observational cohort study in Korea, were included in the present study. Patients were categorized into three groups by serum ALP tertiles as follows: Tertile 1, ALP <78 U/L; Tertile 2, ALP = 78-155 U/L; Tertile 3, ALP >155 U/L. Tertile 1 was used as the reference category. The primary outcomes were infection-related mortality and hospitalization.RESULTS: A total of 1,455 PD patients were included. The median follow-up period was 32 months. The most common cause of infection-related mortality and hospitalization was PD-related peritonitis. Multivariate Cox regression analyses showed that patients in the highest tertiles of serum ALP levels were at higher risk of infection-related mortality (HR 2.29, 95% CI, 1.42-5.21, P = 0.008) after adjustment for clinical variables. Higher tertiles of serum ALP levels were associated with higher risk of infection-related hospitalization (Tertile 2: HR 1.56, 95% CI, 1.18-2.19, P = 0.009, tertile 3: HR 1.34, 95% CI, 1.03-2.62, P = 0.031).CONCLUSIONS: Our data showed that elevated serum ALP levels were independently associated with a higher risk of infection-related mortality and hospitalization in PD patients.

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