Association between serum calcium levels and prognosis, hematoma volume, and onset of cerebral hemorrhage in patients undergoing hemodialysis

• Published in: BMC nephrology 2019-06, Vol.20 (1), p.210-12, Article 210
• Main Authors: Kitamura, Mineaki, Tateishi, Yohei, Sato, Shuntaro, Kitamura, Satoko, Ota, Yuki, Muta, Kumiko, Yamashita, Hiroshi, Uramatsu, Tadashi, Obata, Yoko, Mochizuki, Yasushi, Nishikido, Masaharu, Izumo, Tsuyoshi, Harada, Takashi, Funakoshi, Satoshi, Matsuo, Takayuki, Tsujino, Akira, Sakai, Hideki, Mukae, Hiroshi, Nishino, Tomoya
• Format: Article
• Language: English
• Subjects: Activities of daily living; Blood pressure; Bone diseases; Brain hemorrhage; Calcium; Calcium (Nutrient); Calcium - blood; Cardiovascular diseases; Case-Control Studies; Cerebral hemorrhage; Cerebral Hemorrhage - blood; Cerebral Hemorrhage - diagnosis; Cerebral Hemorrhage - epidemiology; Cerebral Hemorrhage - etiology; Complications and side effects; Cross-Sectional Studies; Demography; Female; Health aspects; Hematoma; Hemodialysis; Hemoglobin; Hemorrhage; Hospitals; Humans; Japan - epidemiology; Kidney diseases; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - therapy; Male; Medical records; Medical referrals; Middle Aged; Multiple regression analysis; Nephrology; Prognosis; Renal Dialysis - adverse effects; Renal Dialysis - methods; Risk factors; Serum calcium; Stroke
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-019-1400-4

High serum calcium levels should be avoided in patients on hemodialysis (HD) because they can induce cardiovascular diseases and worsen the patient's prognosis. In contrast, low serum calcium levels worsen the prognosis of patients with cerebral hemorrhage in the general population. So far, whether serum calcium levels in patients on HD are associated with cerebral hemorrhage remains unknown. This study aimed to reveal the association between serum calcium and cerebral hemorrhage in patients on HD, including in-hospital death, volume of hematoma, and onset of cerebral hemorrhage. This cross-sectional case-control study included 99 patients on HD with cerebral hemorrhage at a single center between July 1, 2007 and December 31, 2017. Controls included 339 patients on HD at a single HD center between July 1, 2011 and June 30, 2012. Data on serum calcium level, patient demographics, and comorbid conditions were collected, and associations between cerebral hemorrhage and subsequent death were evaluated by multivariate logistic regression analysis. Further, the association of these backgrounds and hematoma volume was evaluated by multiple regression analysis. Of the 99 patients, 32 (32%) died from cerebral hemorrhage. The corrected serum calcium level (odds ratio [OR], 2.49; 95% confidence interval [CI], 1.43-4.35; P