Association between serum calcium levels and prognosis, hematoma volume, and onset of cerebral hemorrhage in patients undergoing hemodialysis View Full Text


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Article Info

DATE

2019-06-07

AUTHORS

Mineaki Kitamura, Yohei Tateishi, Shuntaro Sato, Satoko Kitamura, Yuki Ota, Kumiko Muta, Hiroshi Yamashita, Tadashi Uramatsu, Yoko Obata, Yasushi Mochizuki, Masaharu Nishikido, Tsuyoshi Izumo, Takashi Harada, Satoshi Funakoshi, Takayuki Matsuo, Akira Tsujino, Hideki Sakai, Hiroshi Mukae, Tomoya Nishino

ABSTRACT

BackgroundHigh serum calcium levels should be avoided in patients on hemodialysis (HD) because they can induce cardiovascular diseases and worsen the patient’s prognosis. In contrast, low serum calcium levels worsen the prognosis of patients with cerebral hemorrhage in the general population. So far, whether serum calcium levels in patients on HD are associated with cerebral hemorrhage remains unknown. This study aimed to reveal the association between serum calcium and cerebral hemorrhage in patients on HD, including in-hospital death, volume of hematoma, and onset of cerebral hemorrhage.MethodsThis cross-sectional case-control study included 99 patients on HD with cerebral hemorrhage at a single center between July 1, 2007 and December 31, 2017. Controls included 339 patients on HD at a single HD center between July 1, 2011 and June 30, 2012. Data on serum calcium level, patient demographics, and comorbid conditions were collected, and associations between cerebral hemorrhage and subsequent death were evaluated by multivariate logistic regression analysis. Further, the association of these backgrounds and hematoma volume was evaluated by multiple regression analysis.ResultsOf the 99 patients, 32 (32%) died from cerebral hemorrhage. The corrected serum calcium level (odds ratio [OR], 2.49; 95% confidence interval [CI], 1.43–4.35; P < 0.001) and antiplatelet drug use (OR, 3.95; 95% CI, 1.50–10.4; P = 0.005) had significant effects on the prognosis. Moreover, the corrected serum calcium (P = 0.003) and antiplatelet drug use (P = 0.01) were significantly correlated with hematoma volume. In the patients, the corrected serum calcium level (OR, 1.54; 95% CI, 1.07–2.22; P = 0.02) was associated with the onset of cerebral hemorrhage, as was pre-hemodialysis systolic blood pressure (per 10 mmHg) (OR, 1.40; 95% CI, 1.23–1.59; P < 0.001).ConclusionsAlthough the precise mechanisms remain unknown, a high serum calcium level is associated with cerebral hemorrhage in patients on HD. Thus, we should pay attentions to a patient’s calcium level. More... »

PAGES

210

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12882-019-1400-4

DOI

http://dx.doi.org/10.1186/s12882-019-1400-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1116886450

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31174486


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18 schema:description BackgroundHigh serum calcium levels should be avoided in patients on hemodialysis (HD) because they can induce cardiovascular diseases and worsen the patient’s prognosis. In contrast, low serum calcium levels worsen the prognosis of patients with cerebral hemorrhage in the general population. So far, whether serum calcium levels in patients on HD are associated with cerebral hemorrhage remains unknown. This study aimed to reveal the association between serum calcium and cerebral hemorrhage in patients on HD, including in-hospital death, volume of hematoma, and onset of cerebral hemorrhage.MethodsThis cross-sectional case-control study included 99 patients on HD with cerebral hemorrhage at a single center between July 1, 2007 and December 31, 2017. Controls included 339 patients on HD at a single HD center between July 1, 2011 and June 30, 2012. Data on serum calcium level, patient demographics, and comorbid conditions were collected, and associations between cerebral hemorrhage and subsequent death were evaluated by multivariate logistic regression analysis. Further, the association of these backgrounds and hematoma volume was evaluated by multiple regression analysis.ResultsOf the 99 patients, 32 (32%) died from cerebral hemorrhage. The corrected serum calcium level (odds ratio [OR], 2.49; 95% confidence interval [CI], 1.43–4.35; P < 0.001) and antiplatelet drug use (OR, 3.95; 95% CI, 1.50–10.4; P = 0.005) had significant effects on the prognosis. Moreover, the corrected serum calcium (P = 0.003) and antiplatelet drug use (P = 0.01) were significantly correlated with hematoma volume. In the patients, the corrected serum calcium level (OR, 1.54; 95% CI, 1.07–2.22; P = 0.02) was associated with the onset of cerebral hemorrhage, as was pre-hemodialysis systolic blood pressure (per 10 mmHg) (OR, 1.40; 95% CI, 1.23–1.59; P < 0.001).ConclusionsAlthough the precise mechanisms remain unknown, a high serum calcium level is associated with cerebral hemorrhage in patients on HD. Thus, we should pay attentions to a patient’s calcium level.
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24 schema:keywords HD centers
25 ResultsOf
26 analysis
27 antiplatelet drug use
28 association
29 attention
30 background
31 blood pressure
32 calcium
33 calcium levels
34 cardiovascular disease
35 case-control study
36 center
37 cerebral hemorrhage
38 comorbid conditions
39 conditions
40 contrast
41 control
42 cross-sectional case-control study
43 data
44 death
45 demographics
46 disease
47 drug use
48 effect
49 general population
50 hematoma
51 hematoma volume
52 hemodialysis
53 hemorrhage
54 higher serum calcium levels
55 hospital death
56 levels
57 logistic regression analysis
58 low serum calcium levels
59 mechanism
60 multiple regression analysis
61 multivariate logistic regression analysis
62 onset
63 patient demographics
64 patient prognosis
65 patient's calcium level
66 patients
67 population
68 precise mechanism
69 pressure
70 prognosis
71 prognosis of patients
72 regression analysis
73 serum calcium
74 serum calcium levels
75 significant effect
76 single HD center
77 single center
78 study
79 subsequent death
80 systolic blood pressure
81 use
82 volume
83 volume of hematoma
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