Improvements in serum phosphorus, calcium, and parathyroid hormone (PTH) are associated with better survival in hemodialysis (HD) patients, researchers reported.

A team led by Jorge B. Cannata-Andía, MD, of Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, based these findings on a study of 6,797 adult HD patients who participated in COSMOS, a prospective 3-year, multicenter, open-cohort study. Both high and low serum phosphorus, calcium, and PTH were associated with an increased death risk. Serum values associated with the minimum relative risk of death were 4.4 mg/dL for serum phosphorus, 8.8 mg/dL for serum calcium, and 398 pg/mL for serum PTH, the researchers reported online ahead of print in Nephrology Dialysis Transplantation. The lowest mortality risk ranges obtained using the previous values as a base were 3.6–5.2 mg/dL for serum phosphorus, 7.9–9.5 mg/dL for serum calcium, and 168–674 pg/mL for serum PTH.

The investigators found that decreases in serum phosphorus and calcium levels from baseline values greater than 5.2 mg/dL and greater than 9.5 mg/dL, respectively, and increases in serum PTH from a baseline value less than 168 pg/mL were associated with improved survival.