Renal Failure (Dec 2023)

Could long-term dialysis vintage and abnormal calcium, phosphorus and iPTH control accelerate aging among the maintenance hemodialysis population?

  • Yingxin Zhang,
  • Huan Yang,
  • Zhengling Yang,
  • Xiuyong Li,
  • Zhi Liu,
  • Youwei Bai,
  • Guangrong Qian,
  • Han Wu,
  • Ji Li,
  • Yuwen Guo,
  • Shanfei Yang,
  • Lei Chen,
  • Jian Yang,
  • Jiuhuai Han,
  • Shengyin Ma,
  • Jing Yang,
  • Linfei Yu,
  • Runzhi Shui,
  • Xiping Jin,
  • Hongyu Wang,
  • Fan Zhang,
  • Tianhao Chen,
  • Xinke Li,
  • Xiaoying Zong,
  • Li Liu,
  • Jihui Fan,
  • Wei Wang,
  • Yong Zhang,
  • Guangcai Shi,
  • Deguang Wang,
  • Shuman Tao

DOI
https://doi.org/10.1080/0886022X.2023.2250457
Journal volume & issue
Vol. 45, no. 2

Abstract

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Objective Aging is a complex process of physiological dysregulation of the body system and is common in hemodialysis patients. However, limited studies have investigated the links between dialysis vintage, calcium, phosphorus, and iPTH control and aging. The purpose of the current study was to examine these associations.Methods During 2020, a cross-sectional study was conducted in 3025 hemodialysis patients from 27 centers in Anhui Province, China. Biological age was calculated by a formula using chronological age and clinical indicators. The absence of the target range for serum phosphorus (0.87–1.45 mmol/L), corrected calcium (2.1–2.5 mmol/L) and iPTH (130–585 pg/mL) were identified as abnormal calcium, phosphorus, and iPTH control.Results A total of 1131 hemodialysis patients were included, 59.2% of whom were males (669/1131). The mean (standard deviation) of actual age and biological age were 56.07 (12.79) years and 66.94 (25.88), respectively. The median of dialysis vintage was 4.3 years. After adjusting for the confounders, linear regression models showed patients with abnormal calcium, phosphorus, and iPTH control and on hemodialysis for less than 4.3 years (B = 0.211, p = .002) or on hemodialysis for 4.3 years or more (B = 0.302, p < .001), patients with normal calcium, phosphorus, and iPTH control and on hemodialysis for 4.3 years or more (B = 0.087, p = .013) had a higher biological age.Conclusion Our findings support the hypothesis that long-term hemodialysis and abnormal calcium, phosphorus, and iPTH control may accelerate aging in the hemodialysis population. Further studies are warrant to verify the significance of maintaining normal calcium-phosphorus metabolism in aging.

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