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Association between plasma phosphorus and renal outcome: A prospective cohort of patients majorly with

Damin Xu1, Jicheng Lv1, Jinwei Wang1

  • 1Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, National Health and Family Planning Commission of the People's Republic of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing, China.

Nephrology (Carlton, Vic.)
|January 16, 2016
PubMed

Insights

Elevated blood phosphorus is a significant risk factor for adverse renal outcomes in Chinese patients with chronic kidney disease (CKD). Time-averaged phosphorus levels, rather than baseline levels, more strongly predict kidney disease progression and poor renal prognosis.

Area of Science:

  • Nephrology
  • Biochemistry
  • Epidemiology

Background:

  • Inconsistent findings exist regarding the association between blood phosphorus and renal outcomes.
  • Studies in Asian populations, particularly concerning chronic kidney disease (CKD) and glomerulonephritis, are limited.

Purpose of the Study:

  • To prospectively investigate the association between blood phosphorus levels and adverse renal outcomes.
  • To examine the predictive value of baseline and time-averaged phosphorus in Chinese CKD patients.

Main Methods:

  • A cohort of 1430 Chinese patients with CKD, primarily due to glomerulonephritis, was studied.
  • Linear regression analyzed the relationship between phosphorus and estimated glomerular filtration rate (eGFR) slope.
  • Cox regression assessed the association between phosphorus and composite renal outcomes (eGFR halving, end-stage renal disease, or death).

Main Results:

  • Time-averaged plasma phosphorus was independently associated with a faster decline in eGFR.
  • Increases in both baseline and time-average phosphorus correlated with higher risks of composite renal outcomes.
  • Patients in the top quartile of time-average phosphorus had a significantly increased risk of adverse renal outcomes compared to the bottom quartile.

Conclusions:

  • Plasma phosphorus is an independent risk factor for adverse renal outcomes in Chinese CKD patients with glomerulonephritis.
  • Time-averaged phosphorus levels provide a stronger prediction of renal prognosis than baseline levels.
Abstract

Keywords:
chronic kidney diseasecohort studyend stage renal diseaseglomerulonephritisphosphorusrenal outcome

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