Phosphorus binders and survival on hemodialysis
Tamara Isakova1, Orlando M Gutiérrez, Yuchiao Chang
1Renal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Journal of the American Society of Nephrology : JASN
|December 19, 2008
Summary
Treatment with phosphorus binders significantly improves survival in new hemodialysis patients. This finding suggests phosphorus binders may be crucial for managing mortality risk in this population.
Area of Science:
- Nephrology
- Clinical Epidemiology
Background:
- Hyperphosphatemia is a known mortality risk factor in hemodialysis patients.
- Limited data exist on the impact of phosphorus binder therapy on patient survival.
Purpose of the Study:
- To investigate the association between phosphorus binder therapy and all-cause mortality in incident hemodialysis patients.
- To compare survival rates between treated and untreated patients using various analytical approaches.
Main Methods:
- Analysis of a prospective cohort study involving 10,044 incident hemodialysis patients.
- Utilized Cox proportional hazards analyses, intention-to-treat, as-treated, and propensity score-matched cohort analyses.
- Examined 1-year all-cause mortality as the primary outcome.
Main Results:
- Phosphorus binder treatment was independently associated with decreased 1-year all-cause mortality.
- This association remained consistent across intention-to-treat, as-treated, and matched analyses.
- Results were independent of baseline and follow-up serum phosphate levels.
Conclusions:
- Phosphorus binder therapy is independently linked to improved survival in incident hemodialysis patients.
- Further research, including randomized trials in predialysis CKD patients, is warranted.
- Phosphorus binders may play a vital role in reducing mortality in dialysis populations.
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