ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2018
Prognostic significance of pre-end-stage renal disease serum alkaline phosphatase for post-end-stage renal disease mortality in late-stage chronic kidney disease patients transitioning to dialysis.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 37 citations in OpenAlex.
- Nondialytic Care vs Dialysis Transition on Hospitalization: Outcomes in Veterans With Advanced Chronic Kidney Disease.Mayo Clinic proceedings · 2026Article
- Distinct longitudinal trajectories of alkaline phosphatase and parathyroid hormone at dialysis initiation predict mortality in incident hemodialysis patients.BMC nephrology · 2026Article
- Parathyroid hormone and alkaline phosphatase are associated with fracture risk in non-dialysis-dependent chronic kidney disease.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Liver fraction of circulating alkaline phosphatase is elevated in chronic kidney disease and associates with mortality in patients treated with haemodialysis.Clinical kidney journal · 2026Article
- Retrospective cohort study on alkaline phosphatase and ICU mortality rate of multiple myeloma.Scientific reports · 2025Article
- Higher Serum Alkaline Phosphatase Is a Risk Factor of Death and Fracture: A Nationwide Cohort Study of Japanese Patients on Dialysis.Kidney360 · 2025Article
- Data-driven, two-stage machine learning algorithm-based prediction scheme for assessing 1-year and 3-year mortality risk in chronic hemodialysis patients.Scientific reports · 2023Observational
- Prognostic significance of albumin to alkaline phosphatase ratio in critically ill patients with acute kidney injury.Clinical and experimental nephrology · 2022Article
- Characteristics and predictors of mortality on haemodialysis in Brazil: a cohort of 5,081 incident patients.BMC nephrology · 2022Article
- Laxative use in patients with advanced chronic kidney disease transitioning to dialysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Article
- Laxative Use and Change in Estimated Glomerular Filtration Rate in Patients With Advanced Chronic Kidney Disease.Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2021Article
- Burden of chronic kidney disease and rapid decline in renal function among adults attending a hospital-based diabetes center in Northern Europe.BMJ open diabetes research & care · 2021Article
- Interaction of Serum Alkaline Phosphatase and Folic Acid Treatment on Chronic Kidney Disease Progression in Treated Hypertensive Adults.Frontiers in pharmacology · 2021Article
- Intestinal alkaline phosphatase modulation by food components: predictive, preventive, and personalized strategies for novel treatment options in chronic kidney disease.The EPMA journal · 2020Review
- Association between serum alkaline phosphatase and renal outcome in patients with type 2 diabetes mellitus.Renal failure · 2020Article
- Epigenetic Modifiers as Potential Therapeutic Targets in Diabetic Kidney Disease.International journal of molecular sciences · 2020Review
- Hidden Hypocalcemia as a Risk Factor for Cardiovascular Events and All-Cause Mortality among Patients Undergoing Incident Hemodialysis.Scientific reports · 2020Article
- Liver Function Enzymes are Potential Predictive Markers for Kidney Allograft Dysfunction.Advancements in journal of urology and nephrology · 2020Article
- Serum alkaline phosphatase levels correlate with long-term mortality solely in peritoneal dialysis patients with residual renal function.Renal failure · 2019Article
- Serum alkaline phosphatase and the risk of coronary heart disease, stroke and all-cause mortality: Tehran Lipid and Glucose Study.BMJ open · 2018Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 3 countries.
Funding
Abstract
Background: Higher serum alkaline phosphatase (ALP) levels have been associated with excess mortality in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) and end-stage renal disease (ESRD). However, little is known about the impact of late-stage NDD-CKD ALP levels on outcomes after dialysis initiation. Methods: Among 17 732 US veterans who transitioned to dialysis between October 2007 and September 2011, we examined the association of serum ALP levels averaged over the last 6 months of the pre-ESRD transition period ('prelude period') with all-cause, cardiovascular and infection-related mortality following dialysis initiation, using Cox (for all-cause mortality) and competing risk (for cause-specific mortality) regressions adjusted for demographics, comorbidities, medications, estimated glomerular filtration rate and serum albumin levels over the 6-month prelude period, and vascular access type at dialysis initiation. Results: During a median follow-up of 2.0 (interquartile range, 1.1-3.2) years following dialysis initiation, a total of 9196 all-cause deaths occurred. Higher ALP levels were incrementally associated with higher all-cause, cardiovascular and infection-related mortality. Compared with patients in the lowest ALP quartile (<66.0 U/L), those in the highest quartile (≥111.1 U/L) had multivariable-adjusted hazard/subhazard ratios (95% confidence interval) of 1.42 (1.34-1.51), 1.43 (1.09-1.88) and 1.39 (1.09-1.78) for all-cause, cardiovascular and infection-related mortality, respectively. The associations remained consistent in various subgroups and after further adjustment for liver enzymes, serum phosphorus and intact parathyroid hormone levels. Conclusions: Higher pre-ESRD serum ALP levels are independently associated with higher post-ESRD mortality risk. Further studies are warranted to determine if interventions that lower pre-ESRD ALP levels reduce mortality in incident dialysis patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.