High Serum Phosphate Level as a Risk Factor to Determine Renal Prognosis in Autosomal Dominant Polycystic Kidney Disease: A Retrospective Study

Sato, Masayo; Kataoka, Hiroshi; Ushio, Yusuke; Manabe, Shun; Watanabe, Saki; Akihisa, Taro; Makabe, Shiho; Yoshida, Rie; Iwasa, Naomi; Mitobe, Michihiro; Hanafusa, Norio; Tsuchiya, Ken; Nitta, Kosaku; Mochizuki, Toshio

doi:10.3390/medicines7030013

Cited by 7 publications

(3 citation statements)

References 26 publications

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“…The current results agree with previous research showing anaemia as an indicator for worse CKD outcomes [ 42 ]. The inverse association between kidney failure and haemoglobin levels was also observed in non-diabetic CKD and autosomal dominant polycystic kidney disease G2-G5 CKD patients [ 43 , 44 ]. Erythropoiesis-stimulating agents slowed progressive CKD in a non-dialysis dependent population [ 45 ].…”

Section: Discussionmentioning

confidence: 96%

Development of a Biomarker Panel to Distinguish Risk of Progressive Chronic Kidney Disease

et al. 2020

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Chronic kidney disease (CKD) patients typically progress to kidney failure, but the rate of progression differs per patient or may not occur at all. Current CKD screening methods are sub-optimal at predicting progressive kidney function decline. This investigation develops a model for predicting progressive CKD based on a panel of biomarkers representing the pathophysiological processes of CKD, kidney function, and common CKD comorbidities. Two patient cohorts are utilised: The CKD Queensland Registry (n = 418), termed the Biomarker Discovery cohort; and the CKD Biobank (n = 62), termed the Predictive Model cohort. Progression status is assigned with a composite outcome of a ≥30% decline in eGFR from baseline, initiation of dialysis, or kidney transplantation. Baseline biomarker measurements are compared between progressive and non-progressive patients via logistic regression. In the Biomarker Discovery cohort, 13 biomarkers differed significantly between progressive and non-progressive patients, while 10 differed in the Predictive Model cohort. From this, a predictive model, based on a biomarker panel of serum creatinine, osteopontin, tryptase, urea, and eGFR, was calculated via linear discriminant analysis. This model has an accuracy of 84.3% when predicting future progressive CKD at baseline, greater than eGFR (66.1%), sCr (67.7%), albuminuria (53.2%), or albumin-creatinine ratio (53.2%).

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Section: Discussionmentioning

confidence: 96%

Development of a Biomarker Panel to Distinguish Risk of Progressive Chronic Kidney Disease

et al. 2020

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“…Phosphate levels have been shown to affect patient prognoses within a range of studies [ 25 , 26 , 27 , 28 ]. Similar to prior research, our study also revealed that phosphate levels are an important factor that influenced hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

Associations between Phosphate Concentrations and Hospital Mortality in Critically Ill Patients Receiving Mechanical Ventilation

Kim

et al. 2022

JCM

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Phosphate concentrations change continuously throughout hospitalization; however, it is unclear which available phosphate measures are most clinically important for predicting hospital mortality. Therefore, we investigated phosphate concentrations in association with hospital mortality following admission to the intensive care unit. We retrospectively enrolled all adult patients receiving mechanical ventilation. Phosphate concentrations were divided into three categories: initially measured phosphate (iP); maximum–minimum phosphate values (ΔP); and phosphate arithmetic average (Pmean). In total, 175 patients were enrolled. The hospital mortality rate was 32.6%, and the most common primary diagnosis was respiratory failure. In multivariable logistic regression analyses, the odds ratios for hospital mortality in association with ΔP and Pmean values were 1.56 and 2.13, respectively (p < 0.0001). According to the obtained receiver operating characteristic curve, ΔP (0.75) and Pmean (0.72) each showed a fair predictive power for hospital mortality. In evaluating relative risks, we found that higher concentrations of Pmean and ΔP were each associated with a higher hospital mortality. ΔP and Pmean values were significantly associated with hospital mortality in critically ill patients, compared to iP. These findings showed that throughout hospitalization, it is important to reduce phosphate level fluctuations and maintain appropriate phosphate concentrations through consistent monitoring and corrections.

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“…Before devising personalized medicine approaches in patients with CKD, high-quality databases must be created and risk factors for the acceleration of the CKD progression must be identified (113,115,118,119,(124)(125)(126)(127)(128)(129), paying attention to attributes such as sex differences or ages (130,131). Indeed, it has been reported that even data used in AI should be divided according to sex and attribute, which makes collecting data disaggregated by age and sex essential if AI is to fulfill its promise of improving outcomes for everyone (132)(133)(134)(135).…”

Section: Attribute-based Medicine For Patients With Obesity and Ckdmentioning

confidence: 99%

Visceral fat and attribute-based medicine in chronic kidney disease

Kataoka

Nitta²,

Hoshino³

2023

Front. Endocrinol.

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Visceral adipose tissue plays a central role in obesity and metabolic syndrome and is an independent risk factor for both cardiovascular and metabolic disorders. Increased visceral adipose tissue promotes adipokine dysregulation and insulin resistance, leading to several health issues, including systemic inflammation, oxidative stress, and activation of the renin-angiotensin-aldosterone system. Moreover, an increase in adipose tissue directly and indirectly affects the kidneys by increasing renal sodium reabsorption, causing glomerular hyperfiltration and hypertrophy, which leads to increased proteinuria and kidney fibrosis/dysfunction. Although the interest in the adverse effects of obesity on renal diseases has grown exponentially in recent years, the relationship between obesity and renal prognosis remains controversial. This may be attributed to the long clinical course of obesity, numerous obesity-related metabolic complications, and patients’ attributes. Multiple individual attributes influencing the pathophysiology of fat accumulation make it difficult to understand obesity. In such cases, it may be effective to elucidate the pathophysiology by conducting research tailored to individual attributes from the perspective of attribute-based medicine/personalized medicine. We consider the appropriate use of clinical indicators necessary, according to attributes such as chronic kidney disease stage, level of visceral adipose tissue accumulation, age, and sex. Selecting treatments and clinical indicators based on individual attributes will allow for advancements in the clinical management of patients with obesity and chronic kidney disease. In the clinical setting of obesity-related nephropathy, it is first necessary to accumulate attribute-based studies resulting from the accurate evaluation of visceral fat accumulation to establish evidence for promoting personalized medicine.

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High Serum Phosphate Level as a Risk Factor to Determine Renal Prognosis in Autosomal Dominant Polycystic Kidney Disease: A Retrospective Study

Cited by 7 publications

References 26 publications

Development of a Biomarker Panel to Distinguish Risk of Progressive Chronic Kidney Disease

Development of a Biomarker Panel to Distinguish Risk of Progressive Chronic Kidney Disease

Associations between Phosphate Concentrations and Hospital Mortality in Critically Ill Patients Receiving Mechanical Ventilation

Visceral fat and attribute-based medicine in chronic kidney disease

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