Phosphorus and Survival

Cannata-Andía, Jorge B.; Naves-Díaz, Manuel

doi:10.1681/asn.2008121277

Cited by 15 publications

(7 citation statements)

References 14 publications

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“…It is well known that both hyperphosphatemia and elevated calcium-phosphate product are associated with an increased risk of death. [37][38][39] In our study, DSE+ response, male gender, older age, and longer HD duration were independent predictors of cardiovascular mortality. Old people and men present higher risk of CAD than young people and women, also in absence of ESRD.…”

Section: Discussionsupporting

confidence: 49%

“…In our study, survival was worse in older patients and in the presence of higher levels of phosphatemia, while DSE+ response was not related to total mortality. It is well known that both hyperphosphatemia and elevated calcium‐phosphate product are associated with an increased risk of death . In our study, DSE+ response, male gender, older age, and longer HD duration were independent predictors of cardiovascular mortality.…”

Section: Discussionsupporting

confidence: 47%

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Dipyridamole stress echocardiography in diagnosis and prognosis of hemodialysis patients with asymptomatic coronary disease

Rivera

Mircoli

Bonforte

et al. 2011

Hemodialysis International

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The prevalence of coronary artery disease (CAD) is high in hemodialysis (HD) patients. The aim of the study was to assess the diagnostic and prognostic value of dipyridamole stress echocardiography (DSE) in nondiabetic HD patients without signs or symptoms of CAD. In 51 out of 158 evaluated HD patients (21 females, age 67 [33-85] years, HD duration 38 [9-271] months), resting echocardiography and DSE were performed. Exclusion criteria were known CAD, diabetes mellitus, and pulmonary and oncologic pathologies. Logistic regression analysis was carried out to identify predictors of abnormal DSE response, while Cox regression analysis was performed to determine variables associated with total and cardiovascular mortality, after 43.3 (11-60) months of follow-up. Seven patients (14%) showed a positive response to DSE (DSE+). In 5/7, CAD was documented by angiography: All of them underwent coronary revascularization. DSE+ patients had significantly smaller body mass index than patients with a negative response (DSE-): 21.7 ± 1.9 vs. 25.1 ± 3.4 kg/m(2) (p = 0.018). During follow-up, 16 (31%) patients died. Older age hazard ratio [HR = 1.07; confidence interval (CI) = 1.01-1.12; p = 0.02] and higher plasma phosphate levels (HR = 10.41; CI = 2.30-47.17; p < 0.01) were predictors of total mortality. Male gender (HR = 22.7; CI = 1.45-354.4; p = 0.03), older age (HR = 1.24; CI = 1.03-1.50; p = 0.02), longer HD duration (HR = 1.13; CI = 1.01-1.26; p = 0.04), and positive response to DSE (HR = 5.82; CI = 1.04-32.65; p = 0.04) were associated with cardiovascular mortality. Ten percent of asymptomatic HD patients had significant CAD, but timely diagnosis did not seem to improve their prognosis. Total survival was associated with age and higher levels of plasma phosphate, while male gender, older age, longer HD duration, and DSE+ were predictors of cardiovascular mortality.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionsupporting

confidence: 47%

Dipyridamole stress echocardiography in diagnosis and prognosis of hemodialysis patients with asymptomatic coronary disease

Rivera

Mircoli

Bonforte

et al. 2011

Hemodialysis International

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“…Since in these patients phosphate is also dependent on the degree of residual kidney function (RKF) and the use of CKD-MBD-specific medication, including phosphate binders, vitamin D analogues and calcimimetics, the dialysis mode is just one aspect in the complex interplay between these components. Currently it is questionable whether the lowering of serum phosphorus itself is associated with improved clinical outcome in patients with ESKD [ 19 ].…”

Section: Haemodiafiltration and Survivalmentioning

confidence: 99%

Clinical evidence on haemodiafiltration

Grooteman

Nubé

Bots

2018

Nephrology Dialysis Transplantation

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Haemodiafiltration (HDF) combines diffusive and convective solute removal in a single treatment session. HDF provides a greater removal of higher molecular weight uraemic retention solutes than conventional high-flux haemodialysis (HD). Recently completed randomized clinical trials suggest better patient survival with online HDF. The treatment is mainly used in Europe and Japan. This review gives a brief overview of the presently available evidence of the effects of HDF on clinical end points, it speculates on possible mechanisms of a beneficial effect of HDF as compared with standard HD and ends with some perspectives for the future.

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“…Hyperphosphatemia stimulates osteogenic transformation and apoptosis of vascular smooth muscle cells, causing expression of genes promoting matrix mineralization and Ca 2+ deposition [48,49,50]. Hyperphosphatemia clinically is linked to accelerated vascular calcification and mortality [51,52,53].…”

Section: Phosphatementioning

confidence: 99%

Calcium Regulation and Bone Mineral Metabolism in Elderly Patients with Chronic Kidney Disease

Tejwani

Qian

2013

Nutrients

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The elderly chronic kidney disease (CKD) population is growing. Both aging and CKD can disrupt calcium (Ca2+) homeostasis and cause alterations of multiple Ca2+-regulatory mechanisms, including parathyroid hormone, vitamin D, fibroblast growth factor-23/Klotho, calcium-sensing receptor and Ca2+-phosphate product. These alterations can be deleterious to bone mineral metabolism and soft tissue health, leading to metabolic bone disease and vascular calcification and aging, termed CKD-mineral and bone disorder (MBD). CKD-MBD is associated with morbid clinical outcomes, including fracture, cardiovascular events and all-cause mortality. In this paper, we comprehensively review Ca2+ regulation and bone mineral metabolism, with a special emphasis on elderly CKD patients. We also present the current treatment-guidelines and management options for CKD-MBD.

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Phosphorus and Survival

Cited by 15 publications

References 14 publications

Dipyridamole stress echocardiography in diagnosis and prognosis of hemodialysis patients with asymptomatic coronary disease

Dipyridamole stress echocardiography in diagnosis and prognosis of hemodialysis patients with asymptomatic coronary disease

Clinical evidence on haemodiafiltration

Calcium Regulation and Bone Mineral Metabolism in Elderly Patients with Chronic Kidney Disease

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