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논문분류	춘계학술대회 초록집
제목	Elevated serum alkaline phosphatase levels and risk of all-cause mortality in dialysis patients
저자	Md Salman Hussain, Ambrish Singh, Abul Kalam Najmi
출판정보	2020; 2020(1):
키워드	Alkaline Phosphatase \| Dialysis \| Hemodialysis \| Nephrology \| Meta-analysis
초록	Conflicting evidence exists on the association of all-cause mortality and serum ALP levels. So, this study is aimed to understand the risk of all-cause mortality associated with elevated serum ALP levels. An extensive literature was searched in PubMed, and Embase database by two independent investigator till January 2020. All those studies were qualified for inclusion which assessed the all-cause mortality risk due to elevated ALP levels in dialysis patients. The primary outcome was to compute the pooled risk of all-cause mortality due to elevated serum ALP levels. The secondary outcome was to compute the all-cause mortality risk due to dialysis modalities, follow-up period, geography, and others. All the statistical analysis was performed using RevMan version 5.3. This meta-analysis was based on 15 studies constituting 395085 dialysis patients with a mean age of 56.39 ± 14.15 years. The pooled risk of all-cause mortality was higher for elevated ALP levels as compared to low ALP levels with a pooled risk ratio (RR) of 1.47 (95% CI: 1.33 – 1.62), p <0.00001 (Fig.1). All-cause mortality risk was higher in peritoneal dialysis (PD) patients with a RR of 1.64 (95% CI: 1.53 – 1.76), p <0.00001 as compared to hemodialysis (HD) patients RR 1.44 (95% CI: 1.29 – 1.61), p <0.00001. Subgroup analysis revealed that studies with follow-up period more than 4 years and Asians had higher risk of all-cause mortality RR 1.53 (95% CI: 1.18 – 1.98), p = 0.001 and RR 1.51 (95% CI: 1.28 – 1.78), p <0.00001 respectively. Elevated serum ALP levels in both HD and PD patients were found to be associated with a higher risk of all-cause mortality. Future well-designed randomized control trials are needed to make the evidence more transparent.
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