This preprint is under consideration at BMC Nephrology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Kenichi Tanaka
Fukushima Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4655-9355
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Although an association between serum phosphorus levels and poor prognosis has been noted in dialysis patients, these associations have been insufficiently reported in non-dialysis dependent chronic kidney disease (NDD-CKD) patients. This study attempted to determine the association between serum phosphorus levels and adverse outcomes in Japanese NDD-CKD patients.
Methods
We investigated the relationships between serum phosphorus levels and adverse outcomes such as kidney events, cardiovascular events, and all-cause death in Japanese NDD-CKD patients, using the longitudinal data of the Fukushima CKD Cohort Study. The study evaluated 822 patients with NDD-CKD enrolled between June 2012 and July 2014. A kidney event was defined as a combination of doubling of the baseline serum creatinine or end-stage renal disease. Cox regression was performed to analyze the relationships of the quartile of the serum phosphorus with kidney events, cardiovascular events, and all-cause death.
Results
Over a median follow-up period of 2.8 years, 46 patients died, there were 50 cardiovascular events, and 102 kidney events occurred. Increased risk of kidney events was observed in patients with higher serum phosphorus, with the lowest risk shown to be a second quartile of serum phosphorus level of 2.9–3.2 mg/dL. Multivariable Cox regression analysis showed an increased risk of kidney events for the highest quartile of the serum phosphorus levels (≥ 3.7 mg/dL) versus the second quartile (2.9–3.2 mg/dL, hazard ratio, 3.62; 95% confidence interval, 1.65–7.94; P = 0.001). A 1 mg/dL increase of the serum phosphorus was associated with an adjusted hazard ratio of 1.66 (95% CI; 1.24–2.20) for the kidney events. There were no significant associations between the serum phosphorus levels at baseline and the risk of cardiovascular events and all-cause death.
Conclusions
Serum phosphorus levels were associated with an increased risk of CKD progression in Japanese NDD-CKD patients.
Keywords
Cardiovascular event, Chronic kidney disease, End-stage renal disease, Kidney event, Mortality, Phosphorus
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
- SupplementalFigure.tiff
Kaplan-Meier curves for the incidence of all-cause death (A), cardiovascular event (B), and kidney event (C) in accordance with the serum calcium levels at baseline in non-dialysis dependent CKD.
- SupplementalTablesPi.docx
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 18 Mar, 2021
No community comments so far
Review #1 received
Received 02 Apr, 2021
Reviewer #2 agreed
On 18 Mar, 2021
Reviewer #1 agreed
On 18 Mar, 2021
Editor assigned
On 08 Mar, 2021
Reviewers invited
Invitations sent on 08 Mar, 2021
Submission checks complete
On 08 Mar, 2021
Editor invited
On 08 Mar, 2021
First submitted
On 01 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
Learn more about our company.
This preprint is under consideration at BMC Nephrology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Kenichi Tanaka
Fukushima Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4655-9355
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 18 Mar, 2021
No community comments so far
Review #1 received
Received 02 Apr, 2021
Reviewer #2 agreed
On 18 Mar, 2021
Reviewer #1 agreed
On 18 Mar, 2021
Editor assigned
On 08 Mar, 2021
Reviewers invited
Invitations sent on 08 Mar, 2021
Submission checks complete
On 08 Mar, 2021
Editor invited
On 08 Mar, 2021
First submitted
On 01 Mar, 2021
Subject Areas
Urology & Nephrology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Although an association between serum phosphorus levels and poor prognosis has been noted in dialysis patients, these associations have been insufficiently reported in non-dialysis dependent chronic kidney disease (NDD-CKD) patients. This study attempted to determine the association between serum phosphorus levels and adverse outcomes in Japanese NDD-CKD patients.
Methods
We investigated the relationships between serum phosphorus levels and adverse outcomes such as kidney events, cardiovascular events, and all-cause death in Japanese NDD-CKD patients, using the longitudinal data of the Fukushima CKD Cohort Study. The study evaluated 822 patients with NDD-CKD enrolled between June 2012 and July 2014. A kidney event was defined as a combination of doubling of the baseline serum creatinine or end-stage renal disease. Cox regression was performed to analyze the relationships of the quartile of the serum phosphorus with kidney events, cardiovascular events, and all-cause death.
Results
Over a median follow-up period of 2.8 years, 46 patients died, there were 50 cardiovascular events, and 102 kidney events occurred. Increased risk of kidney events was observed in patients with higher serum phosphorus, with the lowest risk shown to be a second quartile of serum phosphorus level of 2.9–3.2 mg/dL. Multivariable Cox regression analysis showed an increased risk of kidney events for the highest quartile of the serum phosphorus levels (≥ 3.7 mg/dL) versus the second quartile (2.9–3.2 mg/dL, hazard ratio, 3.62; 95% confidence interval, 1.65–7.94; P = 0.001). A 1 mg/dL increase of the serum phosphorus was associated with an adjusted hazard ratio of 1.66 (95% CI; 1.24–2.20) for the kidney events. There were no significant associations between the serum phosphorus levels at baseline and the risk of cardiovascular events and all-cause death.
Conclusions
Serum phosphorus levels were associated with an increased risk of CKD progression in Japanese NDD-CKD patients.
Figure 1
Figure 2
Loading...