Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Nov;4(11):1805-10.
doi: 10.2215/CJN.01560309. Epub 2009 Sep 3.

Serum alkaline phosphatase and mortality in African Americans with chronic kidney disease

Srinivasan Beddhu  1 , Xiulian Ma, Bradley Baird, Alfred K Cheung, Tom Greene
Affiliations

Serum alkaline phosphatase and mortality in African Americans with chronic kidney disease

Srinivasan Beddhu et al. Clin J Am Soc Nephrol. 2009 Nov.

Abstract

Background and objectives: Serum alkaline phosphatase has been associated with increased mortality in hemodialysis patients but its associations with mortality in chronic kidney disease (CKD) stages III and IV are unknown. Design, settings, participants & measurements: In 1094 participants in the African-American Study of Kidney Disease and Hypertension (AASK) database, the associations of serum alkaline phosphatase with mortality and cardiovascular events were examined in Cox models.

Results: The mean (+/-SD) age was 54 +/- 11 yr, and 61% were men. The median alkaline phosphatase was 80 IU/L, and interquartile range was 66 to 97 IU/L. The mean follow-up was 4.6 yr. There were 105 (9.6%) all-cause deaths and 149 (13.6%) cardiovascular events. Each doubling of serum alkaline phosphatase was significantly associated with increased hazard [hazard ratio (HR) 1.60, 95% confidence interval (CI) 1.08 -2.36] of all-cause mortality adjusted for demographics, drug and blood pressure groups, and comorbidity. With further adjustment for liver function tests as well as serum calcium and phosphorus, each doubling of serum alkaline phosphatase remained significantly associated with increased mortality (HR 1.55, 95% CI 1.03 to 2.33). Serum alkaline phosphatase was not significantly associated with increased risk of cardiovascular events.

Conclusions: Independent of liver function tests and serum calcium and phosphorus, higher levels of serum alkaline phosphatase are associated with increased mortality in the CKD population. Further studies are warranted to identify the potential mechanisms for this association.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Associations of serum alkaline phosphatase groups with survival in the AASK cohort.
See this image and copyright information in PMC

References

    1. Lomashvili KA, Garg P, Narisawa S, Millan JL, O'Neill WC: Upregulation of alkaline phosphatase and pyrophosphate hydrolysis: Potential mechanism for uremic vascular calcification. Kidney Int 73: 1024– 1030, 2008 - PMC - PubMed
    1. Narisawa S, Harmey D, Yadav MC, O'Neill WC, Hoylaerts MF, Millan JL: Novel inhibitors of alkaline phosphatase suppress vascular smooth muscle cell calcification. J Bone Miner Res 22: 1700– 1710, 2007 - PubMed
    1. Sigrist MK, Taal MW, Bungay P, McIntyre CW: Progressive vascular calcification over 2 years is associated with arterial stiffening and increased mortality in patients with stages 4 and 5 chronic kidney disease. Clin J Am Soc Nephrol 2: 1241– 1248, 2007 - PubMed
    1. Lee GH, Benner D, Regidor DL, Kalantar-Zadeh K: Impact of kidney bone disease and its management on survival of patients on dialysis. J Ren Nutr 17: 38– 44, 2007 - PubMed
    1. Blayney MJ, Pisoni RL, Bragg-Gresham JL, Bommer J, Piera L, Saito A, Akiba T, Keen ML, Young EW, Port FK: High alkaline phosphatase levels in hemodialysis patients are associated with higher risk of hospitalization and death. Kidney Int 75: 1114, 2009 - PubMed

Publication types