Phosphorus and mortality risk in end-stage renal disease: A meta-analysis

Hou, Yue; Li, Xiujiang; Sun, Liguang; Qu, Zhen; Jiang, Lili; Du, Yujun

doi:10.1016/j.cca.2017.09.005

Cited by 35 publications

(20 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, severe acute hypophosphatemia may cause cardiac and respiratory failure, leading to death [ 9 ]. On the other hand, high extracellular P i is similarly associated with adverse health outcomes, including coronary artery calcification, worsening renal function, premature aging, and increased mortality [ 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Importance of Dietary Phosphorus for Bone Metabolism and Healthy Aging

Serna

Bergwitz

2020

Nutrients

View full text Add to dashboard Cite

Inorganic phosphate (Pi) plays a critical function in many tissues of the body: for example, as part of the hydroxyapatite in the skeleton and as a substrate for ATP synthesis. Pi is the main source of dietary phosphorus. Reduced bioavailability of Pi or excessive losses in the urine causes rickets and osteomalacia. While critical for health in normal amounts, dietary phosphorus is plentiful in the Western diet and is often added to foods as a preservative. This abundance of phosphorus may reduce longevity due to metabolic changes and tissue calcifications. In this review, we examine how dietary phosphorus is absorbed in the gut, current knowledge about Pi sensing, and endocrine regulation of Pi levels. Moreover, we also examine the roles of Pi in different tissues, the consequences of low and high dietary phosphorus in these tissues, and the implications for healthy aging.

show abstract

Section: Introductionmentioning

confidence: 99%

Importance of Dietary Phosphorus for Bone Metabolism and Healthy Aging

Serna

Bergwitz

2020

Nutrients

View full text Add to dashboard Cite

show abstract

“…More recently, Hou et al’s meta-analysis of nine cohort studies (including a total of 1,992,869 patients with ESRD requiring dialysis) revealed that both abnormally high and abnormally low serum phosphate levels were independently associated with an increased risk of all-cause mortality in this population (hazard ratio (HR) [95% confidence interval (CI)] = 1.39 [1.31–1.47] and 1.16 [1.06–1.28], respectively). Moreover, serum phosphate levels were non-linearly associated with all-cause mortality in dialysis-dependent patients with ESRD [ 27 ].…”

Section: Phosphatementioning

confidence: 99%

Uremic Toxins and Clinical Outcomes: The Impact of Kidney Transplantation

Liabeuf

Cheddani

Massy

2018

Toxins

View full text Add to dashboard Cite

Non-transplanted and transplanted patients with chronic kidney disease (CKD) differ in terms of mortality and the risk of clinical events. This difference is probably due to the difference of both traditional and non-traditional risk factors. Uremic retention solutes may constitute important non-traditional risk factors in this population. In the present review, we selected a set of uremic toxins that have been associated with harmful effects, and are an appealing target for adjuvant therapy in CKD. For each toxin reviewed here, relevant studies were selected and the relationship with hard clinical outcomes of uremic toxins were compared between non-transplanted CKD patients and transplanted patients taking into account the level of glomerular filtration rate in these two situations.

show abstract

“…The interplay among protein intake, sP, and serum albumin (sAlb) levels raises a clinical conundrum when managing patients' sP. Hyperphosphatemia and hypoalbuminemia are independent risk factors for mortality among dialysis patients, thus clinicians may be wary of correcting one risk factor at the "expense" of the other [2][3][4][5]. Reducing dietary protein consumption, while limiting phosphate intake, can result in reduced sAlb, decreased normalized protein catabolic rate (nPCR), and protein-energy wasting (PEW).…”

Section: Introductionmentioning

confidence: 99%

Changes in serum albumin and other nutritional markers when using sucroferric oxyhydroxide as phosphorus binder among hemodialysis patients: a historical cohort study

Kalantar‐Zadeh

Ficociello

Parameswaran

et al. 2019

Preprint

View full text Add to dashboard Cite

Background Elevated serum phosphorus concentrations are common among maintenance hemodialysis patients. Protein is a major source of dietary phosphate, but restriction of protein intake can result in hypoalbuminemia and protein-energy wasting. We hypothesized that sucroferric oxyhydroxide (SO), a potent phosphate binder with a low pill burden, may reduce serum phosphorus levels in hemodialysis patients with hypoalbuminemia without adversely impacting albumin levels or dietary intake of protein.Methods We retrospectively examined de-identified data from 79 adult, in-center hemodialysis patients with baseline hypoalbuminemia (≤ 3.5 g/dL) switched to SO as part of routine clinical care for at least 1 year. Temporal changes (3-month intervals from baseline through Q4) in phosphate binder pill burden, serum phosphorous levels, nutritional markers, and equilibrated Kt/V were analyzed. Data from a matched reference group of non-hypoalbuminemic patients ( N = 79) switched to SO were also examined.Results SO therapy was associated with a mean reduction of 45.7% and 45.1% in daily phosphate binder pill burden, and a mean reduction of 0.4 mg/dL and 0.51 mg/dL in serum phosphorus levels for the hypoalbuminemic and non-hypoalbuminemic patients, respectively. Hypoalbuminemic patients demonstrated significant increases in mean serum albumin levels from 3.50 mg/dL at baseline to 3.69, 3.74, 3.70, and 3.69 mg/dL during Q1 through Q4, respectively ( P < 0.0001), whereas serum albumin levels remained unchanged in the non-hypoalbuminemic group.Conclusions Both hypoalbuminemic and non-hypoalbuminemic patients switching to SO exhibited significant reductions in serum phosphorus concentrations and daily phosphate binder pill burden. Among hypoalbuminemic patients, the initiation of SO therapy was also associated with increases in serum albumin, suggesting therapy may have allowed patients to increase their dietary intake of protein.

show abstract

Phosphorus and mortality risk in end-stage renal disease: A meta-analysis

Cited by 35 publications

References 31 publications

Importance of Dietary Phosphorus for Bone Metabolism and Healthy Aging

Importance of Dietary Phosphorus for Bone Metabolism and Healthy Aging

Uremic Toxins and Clinical Outcomes: The Impact of Kidney Transplantation

Changes in serum albumin and other nutritional markers when using sucroferric oxyhydroxide as phosphorus binder among hemodialysis patients: a historical cohort study

Contact Info

Product

Resources

About