Outcomes associated with serum phosphorus level in males with non-dialysis dependent chronic kidney disease

C. P. Kovesdy, J. E. Anderson, K. Kalantar-Zadeh

Research output: Contribution to journalArticle

Abstract

Background/Aims: Hyperphosphatemia is associated with higher mortality and increased incidence of end-stage renal disease in patients with non-dialysis dependent CKD( NDD-CKD), but there has not been a concomitant assessment of mortality and progressive kidney disease that would also account for cumulative effects of hyperphosphatemia. Methods: In order to account for the cumulative effects of abnormal serum phosphorus we examined associations of not only baseline, but also time-averaged serum phosphorus levels with all-cause mortality, the composite ofmortality or ESRD and the slopes of estimated glomerular filtration rate (eGFR), by using Cox models and mixed effects models in a contemporary cohort of 713 males with moderate and advanced NDD-CKD. Results: Higher baseline and time-averaged serum phosphorus were both associated withmortality and with the composite outcome. A 1 mg/dl higher time-averaged serum phosphorus was associated with a multivariable adjusted hazard ratio of all-cause mortality (95% CI) of 1.56 (1.19 - 2.05), p = 0.001. Higher serum phosphorus was associated with a steeper slope of eGFR in unadjusted analyses, but this association became non-significant after multivariable adjustments. Conclusion: The cumulative burden of hyperphosphatemia is associated with increased mortality in patients with moderate and advanced NDD-CKD. Clinical trials are needed to determine if lowering serum phosphorus can result in improved mortality in this population.

Original languageEnglish (US)
Pages (from-to)268-275
Number of pages8
JournalClinical Nephrology
Volume73
Issue number4
StatePublished - Apr 2010

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Chronic Renal Insufficiency
Phosphorus
Hyperphosphatemia
Mortality
Serum
Glomerular Filtration Rate
Chronic Kidney Failure
Kidney Diseases
Proportional Hazards Models
Clinical Trials
Incidence
Population

Keywords

  • Chronic kidney disease
  • Glomerular filtration rate
  • Mortality
  • Phosphorus

ASJC Scopus subject areas

  • Nephrology

Cite this

Outcomes associated with serum phosphorus level in males with non-dialysis dependent chronic kidney disease. / Kovesdy, C. P.; Anderson, J. E.; Kalantar-Zadeh, K.

In: Clinical Nephrology, Vol. 73, No. 4, 04.2010, p. 268-275.

Research output: Contribution to journalArticle

Kovesdy, CP, Anderson, JE & Kalantar-Zadeh, K 2010, 'Outcomes associated with serum phosphorus level in males with non-dialysis dependent chronic kidney disease', Clinical Nephrology, vol. 73, no. 4, pp. 268-275.
Kovesdy, C. P. ; Anderson, J. E. ; Kalantar-Zadeh, K. / Outcomes associated with serum phosphorus level in males with non-dialysis dependent chronic kidney disease. In: Clinical Nephrology. 2010 ; Vol. 73, No. 4. pp. 268-275.
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