Mehrotra and colleagues report that serum phosphate does not predict subsequent death or development of end-stage renal disease in a community-based cohort of people with chronic kidney disease (CKD). This finding conflicts with previous research and questions the relevance of serum phosphate level to outcomes in the context of CKD.
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References
Mehrotra, R. et al. No independent association of serum phosphorus with risk for death or progression to end-stage renal disease in a large screen for chronic kidney disease. Kidney Int. http://dx.doi.org/10.1038/ki.2013.145.
Lowrie, E. G. & Lew, N. L. Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am. J. Kidney Dis. 15, 458–482 (1990).
Block, G. A., Hulbert-Shearon, T. E., Levin, N. W. & Port, F. K. Association of serum phosphorus and calcium x phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am. J. Kidney Dis. 31, 607–617 (1998).
Palmer, S. C. et al. Serum levels of phosphorus, parathyroid hormone, and calcium and risks of death and cardiovascular disease in individuals with chronic kidney disease: a systematic review and meta-analysis. JAMA 305, 1119–1127 (2011).
Tonelli, M., Sacks, F., Pfeffer, M., Gao, Z. & Curhan, G. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation 112, 2627–2633 (2005).
Dhingra, R. et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch. Intern. Med. 167, 879–885 (2007).
Jono, S. et al. Phosphate regulation of vascular smooth muscle cell calcification. Circ. Res. 87, E10–E17 (2000).
Greenland, P., LaBree, L., Azen, S. P., Doherty, T. M. & Detrano, R. C. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291, 210–215 (2004).
Landray, M. J. et al. Prediction of ESRD and death among people with CKD: the Chronic Renal Impairment in Birmingham (CRIB) prospective cohort study. Am. J. Kidney Dis. 56, 1082–1094 (2010).
Ibels, L. S., Alfrey, A. C., Haut, L. & Huffer, W. E. Preservation of function in experimental renal disease by dietary restriction of phosphate. N. Engl. J. Med. 298, 122–126 (1978).
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D. C. Wheeler declares associations with the following companies: Abbott (speakers' bureau, research/grant support), Amgen (consultant, speakers' bureau), Baxter (consultant), Fresenius (speakers' bureau), Genzyme (speakers' bureau, research/grant support), Otsuka (speakers' bureau), Shire (speakers' bureau), Vifor Pharma (speakers' bureau).
R. Haynes declares no competing interests.
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Haynes, R., Wheeler, D. Does serum phosphate predict death and ESRD in CKD patients?. Nat Rev Nephrol 9, 438–439 (2013). https://doi.org/10.1038/nrneph.2013.128
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DOI: https://doi.org/10.1038/nrneph.2013.128