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논문분류	춘계학술대회 초록집
제목	Serum Alkaline Phosphatase and Peritoneal Dialysis Discontinuation: A Prospective Cohort Study
저자	Hojung Lee
출판정보	2026; 2026(1):
키워드	Alkaline Phosphatase, Peritoneal Dialysis, Treatment failure, Mortality, Chronic Kidney Disease
초록	Objectives: Serum alkaline phosphatase (ALP) is a routinely measured biomarker associated with adverse outcomes in chronic kidney disease. However, evidence in peritoneal dialysis (PD) is limited, and the association between ALP and technique failure, a core PD outcome, has not been investigated. We aimed to evaluate the association between serum ALP levels and the risk of technique failure and the composite outcome in a prospective cohort of PD patients. Methods: A total of 501 incident and prevalent PD patients were enrolled in the KoreaN Cohort Study for Outcomes in Patients with Peritoneal Dialysis (KNOW-PD). Baseline serum ALP was analyzed as both a continuous (log-transformed) and categorical variable based on the upper limit of normal (ULN). The primary outcome was technique failure, and the secondary outcome was a composite of technique failure and all-cause mortality. Cox proportional hazards models stratified by PD vintage were applied to estimate hazard ratios (HRs) with multivariable adjustment. Results: During a median follow-up of 2.95 years, technique failure occurred in 159 patients (32%), and the composite outcome occurred in 184 patients (37%). Higher log-transformed ALP was associated with increased risks of technique failure and the composite outcome (adjusted hazard ratio [aHR], 2.07; 95% CI, 1.27–3.35 and aHR, 1.99; 95% CI, 1.25–3.17, respectively). In categorical analyses, patients with serum ALP levels ≥1.0×ULN had significantly higher risks of technique failure and the composite outcome compared with those with serum ALP <0.5×ULN (aHR, 2.00; 95% CI, 1.02–3.93 and aHR, 2.09; 95% CI, 1.10–3.96, respectively). Conclusion: Elevated serum ALP levels were independently associated with an increased risk of technique failure and composite outcomes in patients undergoing PD. These findings suggest that serum ALP may serve as a valuable prognostic marker for adverse PD outcomes, beyond its traditional role in CKD–MBD.
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