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Hyperphosphatemia and risks of acute kidney injury, end-stage renal disease, and mortality in hospitalized patients

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Authors
Moon, Hongran; Chin, Ho Jun; Na, Ki Young; Joo, Kwon Wook; Kim, Yon Su; Kim, Sejoong; Han, Seung Seok
Issue Date
2019-09-18
Publisher
BioMed Central
Citation
BMC Nephrology, 20(1):362
Keywords
Acute kidney injuryEnd-stage renal diseaseHyperphosphatemiaMortalityPhosphorus
Abstract
Background
Hyperphosphatemia is associated with vascular calcification and bone mineral disorders and is a major concern among patients with chronic kidney disease (CKD). However, the relationship between hyperphosphatemia and renal outcome in non-CKD patients has not been studied. Furthermore, the clinical implications of hyperphosphatemia in relation to the risks of acute kidney injury (AKI), end-stage renal disease (ESRD), and mortality after hospitalization remain unresolved.

Methods
A total of 20,686 patients (aged ≥18 years) admitted to Seoul National University Bundang Hospital from January 2013 to December 2013 were retrospectively reviewed. Patients were divided into quartiles according to serum phosphorus level at the time of admission. The odds ratios (ORs) for AKI and hazard ratios (HRs) for ESRD and all-cause mortality were calculated after adjustment of multiple covariates.

Results
AKI developed in 2319 patients (11.2%), with higher ORs for patients in the third and fourth quartiles (1.4 [1.24–1.68] and 2.8 [2.44–3.22], respectively) compared with the first quartile group. During a median follow-up period of 4.0 years, 183 patients (0.88%) developed ESRD and 3675 patients (17.8%) died. Patients in the fourth quartile had higher risks of ESRD and mortality than patients in the first quartile (HRs, 2.3 [1.46–3.75] and 1.4 [1.22–1.49], respectively). These trends remained consistent in patients with an estimated glomerular filtration rate > 60 ml/min/1.73 m2.

Conclusions
Hyperphosphatemia is related to the risks of AKI, ESRD, and mortality, and it may therefore be necessary to monitor serum phosphorus level in hospitalized patients, irrespective of kidney function.
ISSN
1471-2369
Language
English
URI
http://hdl.handle.net/10371/162648
DOI
https://doi.org/10.1186/s12882-019-1556-y
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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