Phosphate is a potential biomarker of disease severity and predicts adverse outcomes in acute kidney injury patients undergoing continuous renal replacement therapy

Jung, Su Young; Kwon, Jaeyeol; Park, Seohyun; Jhee, Jong Hyun; Yun, Hae‐Ryong; Kim, Hyoung Nae; Kee, Youn Kyung; Yoon, Chang Yun; Chang, Tae Ik; Kang, Ea Wha; Park, Sun-Hee; Yoo, Tae Hyun; Kang, Shin Wook; Han, Seung Hyeok

doi:10.1371/journal.pone.0191290

Cited by 45 publications

(72 citation statements)

References 36 publications

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“…In the present study, increased serum phosphate was determined to be an independent predictor for AKI-associated RM, which is in accordance with previously reported findings [28,29]. Furthermore, phosphate has also been verified as a potential biomarker of disease severity and prognosis in AKI patients undergoing continuous renal replacement therapy [30]; this phenomenon was not observed in our study, which included patients with AKI of all stages.…”

Section: Discussionsupporting

confidence: 93%

Risk factors for acute kidney injury among patients with rhabdomyolysis

Yang

Zhou

Wang

et al. 2020

Preprint

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Background Acute kidney injury (AKI) is a life-threatening complication of rhabdomyolysis (RM). The aim of the present study was to assess patients at high risk for the occurrence of AKI defined by the Kidney Disease Improving Global Outcomes criteria and in-hospital mortality. Methods We performed a retrospective study of patients with creatine kinase levels >1000 U/L, who were admitted to the West China Hospital of Sichuan University between January 2011 and March 2019. The sociodemographic, clinical and laboratory data of these patients were obtained from an electronic medical records database, and univariate and multivariate regression analyses were subsequently conducted. Results For the 329 patients included in our study, the incidence of AKI was 61.4%, and the overall mortality rate was 19.8%; furthermore, patients with AKI tended to have higher mortality rates than those without AKI (24.8% vs. 11.8%; P<0.01). The clinical conditions most frequently associated with RM were trauma (28.3%), sepsis (14.6%), bee sting (12.8%), thoracic and abdominal surgery (11.2%) and exercise (7.0%). Furthermore, patients with RM resulting from sepsis, bee sting and acute alcoholism were more susceptible to AKI. The risk factors for the occurrence of AKI among RM patients included age ≥60 years (OR=3.070), chronic alcoholism (OR=3.256), hypertension (OR=4.252), multiple organ dysfunction syndrome (MODS; OR=7.244), high levels of white blood cell count (OR=1.047) and elevated serum phosphorus (OR=5.526). Age ≥60 years (OR=3.188), MODS (OR=2.262), diabetes (OR=2.746) and elevated prothrombin time (OR=1.079) were independent risk factors for in-hospital mortality in RM patients with AKI. Conclusions AKI is independently associated with mortality in patients with RM, and several risk factors were found to be associated with the occurrence of AKI and in-hospital mortality. These findings suggest that, to improve the quality of medical care, the early prevention of AKI should focus on high-risk patients and more effective management.

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Section: Discussionsupporting

confidence: 93%

Risk factors for acute kidney injury among patients with rhabdomyolysis

Yang

Zhou

Wang

et al. 2020

Preprint

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“…Increased serum phosphate levels have been associated with a higher risk of developing AKI among hospitalized patients, 79 as well as a higher risk of short-term mortality among patients with established AKI (Table 3). [80][81][82] The mechanisms responsible for these findings are unclear. However, rapid and severe increases in the extracellular phosphate concentration can result in acute phosphate nephropathy, in which calcium phosphate deposition is found in the tubular lumina, tubular epithelia, and, less commonly, the peritubular interstitium.…”

Section: Clinical Relevance Of Hyperphosphatemia In Akimentioning

confidence: 99%

Dysregulated Mineral Metabolism in AKI

Leaf

Christov

2019

Seminars in Nephrology

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Dysregulated mineral metabolism is a nearly universal sequalae of acute kidney injury (AKI). Abnormalities in circulating mineral metabolites observed in patients with AKI include hypocalcemia, hyperparathyroidism, hyperphosphatemia, decreased vitamin D metabolite levels, and increased fibroblast growth factor 23 levels. We review the pathophysiology of dysregulated mineral metabolism in AKI with a focus on calcium, phosphate, parathyroid hormone, and vitamin D metabolites. We discuss how mineral metabolite levels can serve as novel prognostic markers for incident AKI and other related outcomes in various clinical settings. Finally, we discuss how vitamin D metabolites potentially could be used as novel therapeutic agents for AKI prevention and treatment.

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“…Data was provided by Seung Hyeok Han, which was stored in the dryad database (https://datadryad.org// resource/doi:10.5061/dryad.6v0j9) [11]. The database is a public data repository which contains data uploaded by authors to make their research data available for future research.…”

Section: Data Sourcementioning

confidence: 99%

Higher body mass index is not a protective risk factor for 28-days mortality in critically ill patients with acute kidney injury undergoing continuous renal replacement therapy

et al. 2019

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Background: Acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) is a fatal and common clinical disorder in critically ill patients. Recent studies have shown that the relationship between BMI and the outcome of patients with AKI undergoing CRRT is conflicting. Methods: A retrospective cohort study based on data reuse. Univariate analysis, multi-factor regression analysis and subgroup analyses were used to explore the association of the BMI with the 28-days mortality risk in patients with AKI undergoing CRRT. Results: From January 2009 to September 2016, a total of 1120 cases met the inclusion criteria and were enrolled in this study. The univariate analysis showed that BMI was associated with 28-days mortality of patients with AKI undergoing CRRT, its HR value was 0.98 (0.96, 0.99). The multi-factor regression analysis showed that BMI was not associated with 28-days mortality of patients with AKI undergoing CRRT in the four models, the adjusted HR value of four models were 1.00 (0.96, 1.04), 1.01 (0.97, 1.04), 1.00 (0.96, 1.04) and 1.00 (0.96, 1.04), respectively. The subgroups analyses showed that the BMI was a risk factor of the 28-days mortality in patients with AKI undergoing CRRT when GFR !30 mL/min, its HR value was 1.04 (1.01, 1.09). Conclusion: Higher BMI was not a protective risk of 28-day mortality in patients with AKI undergoing CRRT. Especially, when GFR !30 mL/min, higher BMI increased the risk of the 28-day mortality rate in patients with AKI undergoing CRRT.

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Phosphate is a potential biomarker of disease severity and predicts adverse outcomes in acute kidney injury patients undergoing continuous renal replacement therapy

Cited by 45 publications

References 36 publications

Risk factors for acute kidney injury among patients with rhabdomyolysis

Risk factors for acute kidney injury among patients with rhabdomyolysis

Dysregulated Mineral Metabolism in AKI

Higher body mass index is not a protective risk factor for 28-days mortality in critically ill patients with acute kidney injury undergoing continuous renal replacement therapy

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