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Phosphate and cardiovascular disease

Jessica Kendrick1, Bryan Kestenbaum, Michel Chonchol

  • 1Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, USA. Jessica.Kendrick@ucdenver.edu

Advances in Chronic Kidney Disease
|March 17, 2011
PubMed

Insights

High phosphate levels, even within normal ranges, increase risks for death and cardiovascular events. Further research is needed to confirm the causal link and guide effective treatments for hyperphosphatemia.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Hyperphosphatemia is a significant risk factor for mortality, cardiovascular events (CVE), and vascular calcification in patients with and without kidney disease.
  • Elevated serum phosphate levels, even within the typical laboratory range, are associated with increased risks of death and CVE.

Purpose of the Study:

  • To explore the mechanisms linking elevated phosphate to adverse outcomes.
  • To highlight the urgent need for clinical trials to establish a causal relationship between phosphate levels and cardiovascular disease.

Main Methods:

  • Review of existing epidemiologic data and evidence on potential biological mechanisms.
  • Identification of knowledge gaps regarding the direct effects of phosphate on vascular health and hormonal pathways.

Main Results:

  • Current evidence suggests direct phosphate effects on vascular calcification.
  • Phosphate influences key hormones like fibroblast growth factor-23 and calcitriol.
  • Epidemiologic data strongly link phosphate excess to cardiovascular disease.

Conclusions:

  • The precise mechanisms of phosphate-induced adverse outcomes require further elucidation.
  • Large, randomized clinical trials with hard endpoints are essential to prove or disprove the benefits and risks of phosphate-lowering therapies.

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