Increasing Phosphate Raises Death, CV Risks in Hemodialysis Patients

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PHILADELPHIA—Baseline plasma phosphate level is an important risk factor for cardiovascular events and mortality in hemodialysis (HD) patients, investigators reported at Kidney Week 2011.

A post-hoc analysis of data from 2,773 patients in the AURORA trial showed that each 1 mmol/L increment in plasma phosphate at baseline is associated with a 48% increased risk of a major cardiovascular event, a 34% increased risk of death from any cause, a 53% increased risk of cardiovascular death, a 45% increased risk of an atherosclerotic event, and a 60% increased risk of nonfatal myocardial infarction. Baseline phosphate was not a risk factor for noncardiovascular death, according to researchers.

The study, which was led by Bengt C. Fellstrom, MD, PhD, of Uppsala University Hospital in Uppsala, Sweden, included 506 patients (18%) who were using the phosphate binder sevelamer at baseline, and this was associated with a significant 16% decreased death risk.

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