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Calcium-phosphate product and its impact on mortality in hospitalized patients
Charat Thongprayoon1, Wisit Cheungpasitporn2, Michael A Mao1
1Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Aim:
This study aimed to assess the relationship between admission Calcium-phosphate (CaP) and in-hospital mortality in hospitalized patients.
Methods:
All adult hospitalized patients who had both admission serum calcium and phosphate levels available between years 2009 and 2013 were enrolled. Admission CaP was categorized based on its distribution into six groups (<21, 21-<27, 27-<33, 33 39, 39-<45 and ≥45 mg2 /dL2 ). Multivariate logistic regression was used to assess the association between admission CaP and in-hospital mortality, using the CaP of 27-<33 mg2 /dL2 as the reference group.
Results:
Abut 14 772 patients were included in the analysis. The association between CaP and in-hospital mortality was U-shaped with the lowest in-hospital mortality in CaP of 27-<33 mg2 /dL2 . After adjusting for potential confounders, both CaP <21 and ≥39 mg2 /dL2 were associated with higher in-hospital mortality. Subgroup analysis demonstrated that the highest in-hospital mortality risk in both chronic kidney disease (CKD) and non-CKD patients occurred when CaP ≥ 45 mg2 /dL2 .
Conclusion:
CaP levels on admission were associated with in-hospital mortality. Highest mortality risk was observed in hospitalized patients with admission CaP of ≥45 mg2 /dL2 in both CKD and non-CKD patients.
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