Alkaline Phosphatase and Cumulative Vascular Access Burden in Maintenance Hemodialysis: An Exploratory Clinical Study
7 affiliations
- 1Department of Surgery, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania
- 2Department of Surgery, Railway Clinical Hospital Craiova, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania
- 3Department of Nephrology, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania
- 4Department of Plastic Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- 5Academy of Romanian Scientists, 3 Ilfov Street, 050044 Bucharest, Romania
- 6Research Center for Minimally Invasive Surgery, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania
- 7Department of Oncology, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, 2 Petru Rares Street, 200349 Craiova, Romania
Abstract
Background: Vascular access dysfunction remains a major challenge in maintenance hemodialysis (HD). Although chronic kidney disease–mineral and bone disorder may contribute to vascular pathology, the relationship between mineral metabolism markers and cumulative vascular access deterioration remains poorly defined. Methods: This retrospective single-center study included 74 patients receiving maintenance HD. Cumulative vascular access burden was defined by reinterventions, definitive access losses, and additional vascular accesses. Associations with parathyroid hormone (PTH), calcium, phosphorus, calcium–phosphorus product, and alkaline phosphatase (ALP) were evaluated using group comparisons, correlation analysis, and logistic regression. Results: Patients with cumulative vascular access burden had higher ALP levels than those without burden (92.0 vs. 78.0 U/L, p = 0.010), whereas PTH, calcium, phosphorus, and calcium–phosphorus product did not differ significantly. ALP correlated with cumulative burden (Spearman’s ρ = 0.303, p = 0.009), and this association remained statistically significant after adjustment for age, BMI, PTH, and phosphorus (OR per 10 U/L increase = 1.226, 95% CI 1.059–1.418; p = 0.006). Conclusions: Higher ALP levels were associated with greater cumulative historical vascular access burden after adjustment for selected clinical and biochemical variables. These exploratory findings do not establish the prognostic value of ALP for future vascular access outcomes and require prospective validation.
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BibTeX
@article{marinescu2026alkaline,
title = {{Alkaline Phosphatase and Cumulative Vascular Access Burden in Maintenance Hemodialysis: An Exploratory Clinical Study}},
author = {Daniela Marinescu and Laurențiu Augustus Barbu and Tiberiu Stefăniță Țenea Cojan and Daniela-Teodora Maria and Sorin-Ioan Zaharie and Răzvan Alexandru Marinescu and Valeriu Șurlin and Daniel-Cosmin Caragea and Ana-Maria Ciurea and Romeo Popa},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218472},
url = {https://www.mdpi.com/2077-0383/15/21/8472},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Alkaline Phosphatase and Cumulative Vascular Access Burden in Maintenance Hemodialysis: An Exploratory Clinical Study
AU - Daniela Marinescu
AU - Laurențiu Augustus Barbu
AU - Tiberiu Stefăniță Țenea Cojan
AU - Daniela-Teodora Maria
AU - Sorin-Ioan Zaharie
AU - Răzvan Alexandru Marinescu
AU - Valeriu Șurlin
AU - Daniel-Cosmin Caragea
AU - Ana-Maria Ciurea
AU - Romeo Popa
PY - 2026
DA - 2026/10/30
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218472
UR - https://www.mdpi.com/2077-0383/15/21/8472
AB - Background: Vascular access dysfunction remains a major challenge in maintenance hemodialysis (HD). Although chronic kidney disease–mineral and bone disorder may contribute to vascular pathology, the relationship between mineral metabolism markers and cumulative vascular access deterioration remains poorly defined. Methods: This retrospective single-center study included 74 patients receiving maintenance HD. Cumulative vascular access burden was defined by reinterventions, definitive access losses, and additional vascular accesses. Associations with parathyroid hormone (PTH), calcium, phosphorus, calcium–phosphorus product, and alkaline phosphatase (ALP) were evaluated using group comparisons, correlation analysis, and logistic regression. Results: Patients with cumulative vascular access burden had higher ALP levels than those without burden (92.0 vs. 78.0 U/L, p = 0.010), whereas PTH, calcium, phosphorus, and calcium–phosphorus product did not differ significantly. ALP correlated with cumulative burden (Spearman’s ρ = 0.303, p = 0.009), and this association remained statistically significant after adjustment for age, BMI, PTH, and phosphorus (OR per 10 U/L increase = 1.226, 95% CI 1.059–1.418; p = 0.006). Conclusions: Higher ALP levels were associated with greater cumulative historical vascular access burden after adjustment for selected clinical and biochemical variables. These exploratory findings do not establish the prognostic value of ALP for future vascular access outcomes and require prospective validation.
SN - 2077-0383
ER -