Higher impact of mineral metabolism on cardiovascular mortality in a European hemodialysis population

Background. Cardiovascular disease is the main cause of morbidity and mortality among hemodialysis patients. Chronic renal failure influences a number of factors that cause accelerated atherogenesis, with calcium, phosphorus, and PTH playing key roles. Several studies have demonstrated the influence of these factors on all-cause and cardiovascular mortality in the American hemodialysis population. In the present study we evaluated the variables that influence long-term cardiovascular mortality in a European hemodialysis population. Methods. One hundred and forty-three hemodialysis patients were followed for six years. Several Cox models were used to study the influence of demographic and biochemical data, and comorbid conditions in cardiovascular survival, with a particular interest in mineral metabolism. Results. There was an increased risk of cardiovascular death in patients with serum P >6.5 mg/dL (risk ratio [RR], 2.5), PTH >50 pmol/L (RR, 3.9), Ca x P >52 (RR, 2.8), BB or Bb genotype (RR, 3.8), and in diabetics. Conclusion. There is a stronger influence of mineral metabolism on cardiovascular death among European patients when compared to the American population.