{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:55:40Z","timestamp":1790034940399,"version":"4.0.1"},"reference-count":63,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007308","name":"Swedish Medical Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007308","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholms L\u00e4ns Landsting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002997","name":"Dutch Kidney Foundation","doi-asserted-by":"publisher","award":["SB 142"],"award-info":[{"award-number":["SB 142"]}],"id":[{"id":"10.13039\/501100002997","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,31]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chronic kidney disease\u2013mineral and bone disorder (CKD-MBD) is a common complication of CKD; it is associated with higher mortality in dialysis patients, while its impact in non-dialysis patients remains mostly unknown. We investigated the associations between parathyroid hormone (PTH), phosphate and calcium (and their interactions), and all-cause, cardiovascular (CV) and non-CV mortality in older non-dialysis patients with advanced CKD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used data from the European Quality study, which includes patients aged \u226565\u00a0years with estimated glomerular filtration rate \u226420\u00a0mL\/min\/1.73\u00a0m2 from six European countries. Sequentially adjusted Cox models were used to assess the association between baseline and time-dependent CKD-MBD biomarkers and all-cause, CV and non-CV mortality. Effect modification between biomarkers was also assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 1294 patients, the prevalence of CKD-MBD at baseline was 94%. Both PTH [adjusted hazard ratio (aHR) 1.12, 95% confidence interval (CI) 1.03\u20131.23, P\u00a0=\u00a0.01] and phosphate (aHR 1.35, 95% CI 1.00\u20131.84, P\u00a0=\u00a0.05), but not calcium (aHR 1.11, 95% CI 0.57\u20132.17, P\u00a0=\u00a0.76), were associated with all-cause mortality. Calcium was not independently associated with mortality, but modified the effect of phosphate, with the highest mortality risk found in patients with both hypercalcemia and hyperphosphatemia. PTH level was associated with CV mortality, but not with non-CV mortality, whereas phosphate was associated with both CV and non-CV mortality in most models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>CKD-MBD is very common in older non-dialysis patients with advanced CKD. PTH and phosphate are independently associated with all-cause mortality in this population. While PTH level is only associated with CV mortality, phosphate seems to be associated with both CV and non-CV mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfad100","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T03:25:46Z","timestamp":1685071546000},"page":"2562-2575","source":"Crossref","is-referenced-by-count":36,"title":["Association between CKD-MBD and mortality in older patients with advanced CKD\u2014results from the EQUAL study"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2853-1332","authenticated-orcid":false,"given":"Lorenza","family":"Magagnoli","sequence":"first","affiliation":[{"name":"University of Milan, Department of Health Sciences , Milan , Italy"},{"name":"ASST Santi Paolo e Carlo, Renal Division , Milan , 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Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Torino","sequence":"additional","affiliation":[{"name":"Istituto di Fisiologia Clinica Consiglio Nazionale delle Ricerche (IFC-CNR), Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension , Reggio Calabria, Italy (IT)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetana","family":"Porto","sequence":"additional","affiliation":[{"name":"G.O.M., Azienda Ospedaliera Bianchi-Melacrino-Morelli , Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Szymczak","sequence":"additional","affiliation":[{"name":"Wroclaw Medical University, Department of Nephrology and Transplantation Medicine , Wroclaw , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Krajewska","sequence":"additional","affiliation":[{"name":"Wroclaw Medical University, Department of Nephrology and Transplantation Medicine , Wroclaw , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Drechsler","sequence":"additional","affiliation":[{"name":"University Hospital W\u00fcrzburg, Division of Nephrology , W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Stenvinkel","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Intervention and Technology (CLINTEC) , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pippias","sequence":"additional","affiliation":[{"name":"University of Bristol , Population Health Sciences, Bristol , UK"},{"name":"North Bristol NHS Trust, Renal Unit , Bristol , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedo W","family":"Dekker","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Department of Clinical Epidemiology , Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther N M","family":"de Rooij","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Department of Clinical Epidemiology , Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9507-5301","authenticated-orcid":false,"given":"Christoph","family":"Wanner","sequence":"additional","affiliation":[{"name":"University Hospital W\u00fcrzburg, Division of Nephrology , W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas C","family":"Chesnaye","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location AMC, Medical Informatics, ERA Registry , Amsterdam , The Netherlands"},{"name":"Amsterdam Public Health Research Institute , Quality of Care, Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitty 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