Document Detail


Chronic kidney disease progression and outcome according to serum phosphorus in mild-to-moderate kidney dysfunction.
MedLine Citation:
PMID:  21393493     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Several factors might alter serum phosphate homeostasis and induce hyperhosphatemia in patients with chronic kidney disease (CKD) not requiring dialysis. However, whether and to what extent hyperphosphatemia is associated with a poor prognosis in different CKD patient groups remain to be elucidated.
DESIGN, SETTING, PARTICIPANTS & MEASUREMENTS: We utilized the "Prevenzione Insufficienza Renale Progressiva" (PIRP) database, a large project sponsored by the Emilia-Romagna Health Institute. PIRP is a collaborative network of nephrologists and general practitioners located in the Emilia-Romagna region, Italy, aimed at increasing awareness of CKD complications and optimizing CKD patient care. We identified 1716 patients who underwent a GFR and serum phosphorous assessment between 2004 and 2007. We tested whether phosphate levels ≥4.3 mg/dl are associated with the risk of CKD progression or all causes of death.
RESULTS: Older age and male sex were associated with lower phosphate levels. Instead, higher phosphate levels were noted in patients with diabetes. Patients with phosphate levels ≥4.3 mg/dl were at an increased risk of starting dialysis or dying (hazard ratio 2.04; 95% confidence interval [1.44, 2.90]). Notably, subgroup analyses revealed that the magnitude of the risk associated with hyperphosphatemia varied depending on age, sex, diabetes, and different stages of CKD.
CONCLUSIONS: These analyses lend support to the hypothesis that phosphorous abnormalities might have a negative effect on the residual renal function and prognosis in different groups of CKD patients. However, the risk associated with hyperphosphatemia might vary in specific CKD patient subgroups.
Authors:
Antonio Bellasi; Marcora Mandreoli; Leopoldo Baldrati; Matteo Corradini; Pierpaolo Di Nicolò; Giulio Malmusi; Antonio Santoro
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Publication Detail:
Type:  Journal Article     Date:  2011-03-10
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  6     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-08     Completed Date:  2011-08-18     Revised Date:  2012-09-24    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  883-91     Citation Subset:  IM    
Copyright Information:
© 2011 by the American Society of Nephrology
Affiliation:
Nephrology Dialysis Hypertension Unit, Policlinico S. Orsola-Malpighi, Via P. Palagi 9, 40138 Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Chronic Disease
Disease Progression
Female
Glomerular Filtration Rate*
Humans
Kidney Diseases / blood,  mortality*,  physiopathology
Male
Middle Aged
Phosphorus / blood*
Chemical
Reg. No./Substance:
7723-14-0/Phosphorus
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