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Functional impairment attenuates the association between high serum phosphate and mortality in dialysis patients: a nationwide cohort study
- Source :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 34(7)
- Publication Year :
- 2018
-
Abstract
- Background Both functional impairment and abnormalities in mineral and bone disorder (MBD) parameters are well-known predictors of mortality in dialysis patients. However, previous studies have not evaluated whether functional impairment modifies the association between MBD parameters and mortality. Methods A nationwide prospective cohort study was conducted using data from the Japanese Society for Dialysis Therapy Renal Data Registry collected at the end of 2009 and 2010. The Eastern Cooperative Oncology Group performance status (PS) was used to assess functional status. Cox proportional hazards models were used to assess the associations of baseline functional status, serum phosphate, albumin-corrected calcium and intact parathyroid hormone (PTH) with 1-year all-cause mortality Results By 31 December 2010, 18 447 of 220 054 prevalent dialysis patients (8.4%) had died. Mortality significantly increased with worsening PS grade. PS grade modified the association of serum phosphate levels with mortality (Pinteraction = 0.001). Worsening PS grade attenuated the association of hyperphosphatemia (≥7.4 mg/dL) with mortality, and hyperphosphatemia was no longer significant on mortality among patients with the worst PS grade (hazard ratio = 1.1, 95% confidence interval 0.88–1.39), compared with the level between 3.5 and 4.7 mg/dL. In contrast, hypophosphatemia ( Conclusions Functional impairment was significantly associated with 1-year mortality and attenuated the effect of hyperphosphatemia on mortality among prevalent dialysis patients.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
030232 urology & nephrology
030204 cardiovascular system & hematology
Gastroenterology
Phosphates
03 medical and health sciences
Hyperphosphatemia
0302 clinical medicine
Japan
Renal Dialysis
Internal medicine
Cause of Death
medicine
Risk of mortality
Humans
Prospective Studies
Prospective cohort study
Exercise
Dialysis
Aged
Chronic Kidney Disease-Mineral and Bone Disorder
Transplantation
Proportional hazards model
business.industry
Hazard ratio
Middle Aged
medicine.disease
Survival Rate
Nephrology
Female
Hemodialysis
business
Hypophosphatemia
Biomarkers
Follow-Up Studies
Subjects
Details
- ISSN :
- 14602385
- Volume :
- 34
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
- Accession number :
- edsair.doi.dedup.....a9c314dbb5a584f3fb4c9b5ed91e63a3