Document Detail


Association of dietary phosphorus intake and phosphorus to protein ratio with mortality in hemodialysis patients.
MedLine Citation:
PMID:  20185606     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Epidemiologic studies show an association between higher predialysis serum phosphorus and increased death risk in maintenance hemodialysis (MHD) patients. The hypothesis that higher dietary phosphorus intake and higher phosphorus content per gram of dietary protein intake are each associated with increased mortality in MHD patients was examined.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Food frequency questionnaires were used to conduct a cohort study to examine the survival predictability of dietary phosphorus and the ratio of phosphorus to protein intake. At the start of the cohort, Cox proportional hazard regression was used in 224 MHD patients, who were followed for up to 5 years (2001 to 2006).
RESULTS: Both higher dietary phosphorus intake and a higher dietary phosphorus to protein ratio were associated with significantly increased death hazard ratios (HR) in the unadjusted models and after incremental adjustments for case-mix, diet, serum phosphorus, malnutrition-inflammation complex syndrome, and inflammatory markers. The HR of the highest (compared with lowest) dietary phosphorus intake tertile in the fully adjusted model was 2.37. Across categories of dietary phosphorus to protein ratios of <12, 12 to <14, 14 to <16, and > or =16 mg/g, death HRs were 1.13, 1.00 (reference value), 1.80, and 1.99, respectively. Cubic spline models of the survival analyses showed similar incremental associations.
CONCLUSIONS: Higher dietary phosphorus intake and higher dietary phosphorus to protein ratios are each associated with increased death risk in MHD patients, even after adjustments for serum phosphorus, phosphate binders and their types, and dietary protein, energy, and potassium intakes.
Authors:
Nazanin Noori; Kamyar Kalantar-Zadeh; Csaba P Kovesdy; Rachelle Bross; Debbie Benner; Joel D Kopple
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-02-25
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  5     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-07-06     Revised Date:  2011-07-27    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  683-92     Citation Subset:  IM    
Affiliation:
Harold Simmons Center for Chronic Disease Research and Epidemiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, C1-Annex, Torrance, CA 90502, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers / blood
Cohort Studies
Diet Records
Dietary Proteins / administration & dosage*,  blood
Female
Humans
Inflammation Mediators / blood
Linear Models
Male
Middle Aged
Nutrition Policy
Nutritional Status*
Phosphorus, Dietary / administration & dosage,  adverse effects*,  blood
Proportional Hazards Models
Renal Dialysis / mortality*
Risk Assessment
Risk Factors
Time Factors
Grant Support
ID/Acronym/Agency:
K23 DK61162/DK/NIDDK NIH HHS; M01-RR00425/RR/NCRR NIH HHS; R01 DK078106/DK/NIDDK NIH HHS; R21 DK078012/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Dietary Proteins; 0/Inflammation Mediators; 0/Phosphorus, Dietary
Comments/Corrections

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