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• W2955086666 abstract "Stroke is a major cause of death and the leading cause of disability in patients undergoing hemodialysis (HD). Several conventional factors including male sex, non-intake of antihypertensive drugs, pre-dialysis hypertension, low serum albumin and total cholesterol levels, and high hemoglobin levels are identified as risk factors for cerebral hemorrhage in patients undergoing HD. However, the association between serum calcium levels and cerebral hemorrhage in patients undergoing HD remains unknown. A high serum calcium level in patients undergoing HD affects the prognosis by causing cardiovascular diseases. In contrast, low serum calcium levels are associated with an increasing hematoma volume and poor outcomes in patients with cerebral hemorrhage in the general population (patients not undergoing HD). We investigated the association between corrected serum calcium levels and cerebral hemorrhage in patients undergoing HD. This was a cross-sectional case-control study involving 99 patients on HD with cerebral hemorrhage at a single center between July 2007 and December 2017. The control group included 339 patients who underwent HD at a single HD center between July 2011 and June 2012. Both groups belonged to the same medical zone comprising approximately 1400 patients undergoing HD. Data regarding patient demographics and comorbidities were obtained, and multivariate logistic regression analysis was performed to analyze the risk of onset of cerebral hemorrhage and the risk of death after cerebral hemorrhage. We also investigated factors associated with hematoma volume. Of the 99 patients analyzed, 32 (32%) died of cerebral hemorrhage. Multivariate regression analysis showed the following: 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) significantly affected the prognosis of cerebral hemorrhage. In addition to the patients who died and those who survived, the severity of ADL (mRS) at discharge was also significantly associated with higher calcium levels (p=0.02 by Cochran-Armitage test).Moreover, the hematoma volume was significantly associated with corrected serum calcium levels (β 0.378, standard error [SE] 0.101, P<0.001) and antiplatelet drug use (β 0.240, SE 0.089, P=0.005). Compared with the control group, the corrected serum calcium levels (OR 1.54, 95% CI 1.07–2.22, P=0.02) were significantly associated with the onset of cerebral hemorrhage, pre-dialysis hypertension (OR 1.40/10 mmHg increase, 95% CI 1.23–1.29, P<0.001), and intact-parathyroid hormone levels (OR 1.03/10 pg/mL increase, 95% CI 1.01–1.05, P=0.02). No significant association was observed between serum calcium levels and any of the aforementioned factors.View Large Image Figure ViewerDownload Hi-res image Download (PPT) To our knowledge, this is the first study to clarify the association between serum calcium levels and cerebral hemorrhage in patients undergoing HD. Corrected serum calcium levels were positively associated with poor prognosis, hematoma volume, and the onset of cerebral hemorrhage in patients undergoing HD. These results differ from those observed in the general population. Although the exact mechanisms remain unknown, serum calcium levels need close monitoring in patients undergoing maintenance HD to prevent the onset and progression of cerebral hemorrhage." @default.
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• W2955086666 date "2019-07-01" @default.
• W2955086666 modified "2023-10-17" @default.
• W2955086666 title "MON-144 ASSOCIATION BETWEEN SERUM CALCIUM LEVELS AND THE PROGNOSIS, HEMATOMA VOLUME, AND THE ONSET OF CEREBRAL HEMORRHAGE IN PATIENTS UNDERGOING HEMODIALYSIS" @default.
• W2955086666 doi "https://doi.org/10.1016/j.ekir.2019.05.936" @default.
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