Elevated levels of serum alkaline phosphatase in hemodialysis (HD) patients may predict coronary artery calcification (CAC), which is associated with cardiovascular and mortality in this population.

In a study of 137 HD patients, Ronney Shantouf, MD, of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center in Torrance, Calif., and colleagues found that a calcium artery calcification score (CACS) of 400 or more is five times more likely to occur among patients in the highest tertile of serum alkaline phosphatase (120 mg/dL or higher) compared with those in the second tertile (reference; 85-119 mg/dL), after adjusting for age, gender, presence of diabetes mellitus, Charlson comorbidity score, dialysis vintage, interleukin-6, and serum glutamic oxaloacetic transaminase. The researchers observed no association between the first quartile of serum alkaline phosphatase and the likelihood of a CACS of 400 or more.

The mean CACS for patients with a serum alkaline phosphatase level of 120 mg/dL or higher was about twice that of subjects with lower levels.

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