Prognostic value of preoperative serum alkaline phosphatase for predicting 3-year mortality in patients undergoing kidney transplantation: A retrospective study

Abstract Serum alkaline phosphatase (ALP) levels are related to high-turnover bone disease and reflect vascular calcification and inflammation. ALP has been reported to have a prognostic impact in various cohorts including chronic kidney disease. This study investigated whether preoperative serum ALP level could be used for predicting mortality in patients undergoing kidney transplantation. We retrospectively reviewed 1,718 patients who underwent kidney transplantation between November 2005 and June 2017. Finally, 1,533 patients who met the inclusion criteria were classified into tertiles based on preoperative serum ALP level (< 51, 51–72, > 72 IU/L). The incidence of mortality was compared among the three tertiles, and a stepwise logistic regression analysis was performed to evaluate the predictors for mortality. The incidence of 3-year mortality was the highest in the third tertile (1.0% vs. 2.5% vs. 4.4% in the first, second, and third tertile, respectively, p = 0.003). The third tertile of ALP level (odds ratio [OR] 1.855, 95% CI 1.192–2.886, p = 0.006), age (OR 1.052, 95% CI 1.022–1.082, p = 0.011), and history of hypertension (OR 0.401, 95% CI 0.210–0.765, p = 0.006) remained as independent predictors of mortality. Preoperative serum ALP level was significantly higher in the non-survivor group than in the survivor group (58.00 [44.00–76.00] vs. 75.00 [56.25–113.00], p = 0.003). The optimal cut-off value of serum ALP to predict 3-year mortality was 71 IU/L (area under the curve 0.636, 95% CI 0.554–0.719, p = 0.003). Therefore, preoperative serum ALP level was an independent predictor of 3-year mortality in patients undergoing kidney transplantation.

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Prognostic impact of preoperative serum alkaline phosphatase level on a composite of morbidity and mortality after thoracic endovascular aortic repair

Medicine ◽

10.1097/md.0000000000017173 ◽

2019 ◽

Vol 98 (38) ◽

pp. e17173 ◽

Cited By ~ 1

Author(s):

Sung Yeon Ham ◽

Sang Beom Nam ◽

Dong Woo Han ◽

Ann Hee You ◽

Won Sik Lim ◽

...

Keyword(s):

Alkaline Phosphatase ◽

Alkaline Phosphatase Level ◽

Serum Alkaline Phosphatase ◽

Thoracic Endovascular Aortic Repair ◽

Endovascular Aortic Repair ◽

Morbidity And Mortality ◽

Prognostic Impact ◽

Serum Alkaline Phosphatase Level ◽

Aortic Repair ◽

Preoperative Serum

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Preoperative Serum Alkaline Phosphatase and Clinical Outcome of Off-Pump Coronary Artery Bypass Surgery

Circulation Journal ◽

10.1253/circj.cj-16-1288 ◽

2017 ◽

Vol 81 (6) ◽

pp. 799-805 ◽

Cited By ~ 4

Author(s):

Tae Kyong Kim ◽

Deok Man Hong ◽

Yoon Hyeong Choi ◽

Chang-Hoon Koo ◽

Youn Joung Cho ◽

...

Keyword(s):

Alkaline Phosphatase ◽

Coronary Artery ◽

Clinical Outcome ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Serum Alkaline Phosphatase ◽

Artery Bypass ◽

Off Pump ◽

Preoperative Serum ◽

Pump Coronary Artery Bypass

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Prolonged haemodialysis increases the risk of the impairment of global longitudinal strain in patient after kidney transplantation and a preserved ejection fraction of left ventricle

10.21203/rs.2.14684/v2 ◽

2019 ◽

Author(s):

Marta Obremska ◽

Anna Goździk ◽

Maciej Szymczak ◽

Dorota Zysko ◽

Maria Boratyńska ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Kidney Transplantation ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Stepwise Logistic Regression ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Stepwise Logistic Regression Analysis ◽

Multivariate Stepwise Logistic Regression

Abstract Background. Patients with chronic kidney disease, including these after kidney transplantation (KTx), have higher cardiovascular mortality. Global longitudinal strain (GLS) detects subtle changes in the left ventricle (LV) and is more sensitive predictor of cardiovascular mortality than the LV ejection fraction (LVEF).The aim of this study was to assess the prevalence of impaired GLS among kidney transplant recipients with preserved LVEF. We also aimed to identify possible clinical factors responsible for GLS impairment. Methods. A total of 79 patients following KTx with preserved LVEF and no history of cardiac disease were evaluated. We assessed echocardiogram parameters with the calculation of GLS, laboratory parameters, presence of diabetes, hypertension, duration of haemodialysis (HD) and time after KTx. An impaired GLS value was set on ≥-18%. The multivariate stepwise logistic regression analysis were used to identify the factors related to impaired GLS. Results. Among 79 (42 females, mean age 60.3) kidney transplant recipients with preserved LVEF, 39% had impaired GLS. ROC analysis revealed that the cut-off point for the prediction GLS ≥-18 % by HD duration is more than 28 months (AUC 0.67 (95%CI 0.545-0.79; P=0.007). In multivariate stepwise logistic regression analysis for variables related to impaired GLS duration of HD more than 28month is associated with GLS ≥-18( OR 4.06; 95CI (1.45-11.34) P=0.008). Conclusions. In our study group, a total of 39% of KTx patients with preserved LVEF had impaired GLS. The risk factor of GLS impairment was a prolonged duration of HD (>28months) prior to the transplantation procedure.

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Serum Alkaline Phosphatase as a Predictor of Cardiac and Cerebrovascular Complications after Lumbar Spinal Fusion Surgery in Elderly: A Retrospective Study

Journal of Clinical Medicine ◽

10.3390/jcm8081111 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1111 ◽

Cited By ~ 2

Author(s):

You ◽

Han ◽

Ham ◽

Lim ◽

Song

Keyword(s):

Spinal Fusion ◽

Serum Alkaline Phosphatase ◽

Composite Endpoint ◽

Lumbar Spinal Fusion ◽

Fusion Surgery ◽

Spinal Fusion Surgery ◽

The Third ◽

Cerebrovascular Complications ◽

Preoperative Serum ◽

Lumbar Spinal

We retrospectively enrolled 1395 patients aged > 65 years undergoing posterior lumbar spinal fusion surgery and classified them into tertiles based on serum Alkaline Phosphatase (ALP) levels (<63, 63–79, >79 IU/L). The primary outcome was the incidence of 30-day major adverse cardiac and cerebrovascular events (MACCE; composite endpoint defined as the occurrence of ≥1 of the following events: new-onset myocardial infarction, stroke, or cardiovascular mortality). The incidence of the composite endpoint was the highest in the third serum ALP tertile (0.4% vs. 0.2% vs. 2.2% in the first, second, and third tertile, respectively, p = 0.003). Multivariate analysis showed that the third serum ALP tertile was an independent predictor of the composite endpoint of MACCE (odds ratio 4.507, 95% confidence interval 1.378–14.739, p = 0.013). The optimal cut-off value of preoperative serum ALP showing the best discriminatory capacity to predict postoperative MACCE (measured by receiver-operating characteristic curve analysis) was 83 IU/L (area under curve 0.694, 95% confidence interval 0.574–0.813, p = 0.016). Preoperative serum ALP levels were independently associated with the composite endpoint of postoperative 30-days MACCE. We suggest that serum ALP can be used as a biomarker to predict cardiac and cerebrovascular complications following lumbar spinal fusion surgery in elderly patients.

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