Details

Autor(en) / Beteiligte

• Dominguez, Julie R., MD
• Kestenbaum, Bryan, MD, MS
• Chonchol, Michel, MD
• Block, Geoffrey, MD
• Laughlin, Gail A., PhD
• Lewis, Cora E., MD, MSPH
• Katz, Ronit, DPhil
• Barrett-Connor, Elizabeth, MD
• Cummings, Steve, MD
• Orwoll, Eric S., MD
• Ix, Joachim H., MD, MAS

Titel

Relationships Between Serum and Urine Phosphorus With All-Cause and Cardiovascular Mortality: The Osteoporotic Fractures in Men (MrOS) Study

Ist Teil von

• American journal of kidney diseases, 2013-04, Vol.61 (4), p.555-563

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2013

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Background Serum phosphorus is associated with cardiovascular disease (CVD) in the general population, but may not comprehensively reflect phosphorus homeostasis. Whether urine phosphorus-creatinine ratio (a marker of intestinal absorption) or urine fractional excretion of phosphorus (FEPi ; a marker of urinary phosphorus handling) is associated with risk of mortality or CVD is uncertain. Study Design Prospective observational study. Setting & Participants 1,325 community-dwelling men 65 years or older participating in the MrOS Study. Predictor Serum phosphorus, urine phosphorus-creatinine ratio, and FEPi. Outcomes All-cause and CVD death. Results Mean age was 74 ± 6 (SD) years, estimated glomerular filtration rate was 75 ± 16 mL/min/1.73 m2 , and serum phosphorus level was 3.2 ± 0.4 mg/dL. During a median follow-up of 9.3 years, there were 364 (120 CVD) deaths. After adjustment for demographics, CVD risk factors, and kidney function, the risks of all-cause death in the highest quartiles of serum phosphorus (≥3.6 mg/dL), urine phosphorus-creatinine ratio (≥0.55), and FEPi (≥18%) were 1.63 (95% CI, 1.23-2.17), 1.22 (95% CI, 0.90-1.65), and 0.88 (95% CI, 0.64-1.23), respectively, compared to the lowest quartiles of each. Results were similar for CVD death. Results also were similar in those with estimated glomerular filtration rate ≥60 and <60 mL/min/1.73 m2. Limitations Older all-male cohort. Few had advanced chronic kidney disease. Spot urine specimens were used. Conclusions In community-living older men, higher serum phosphorus concentrations are associated with all-cause and CVD death. In contrast, urine phosphorus-creatinine ratio and FEPi are not. These findings do not support using urine phosphorus-creatinine ratio or FEPi as adjuvant measures to predict risk of mortality or CVD in the general population.