SAN DIEGO—High phosphorus levels in hemodialysis (HD) patients is associated with an elevated risk of cerebral hemorrhage, according to the findings of a Japanese study presented at Kidney Week.

In an observational study of 3,598 HD outpatients, Shunsuke Yamada, MD, PhD,of Kyushu University in Fukuoka, and colleagues found that, compared with patients in the first quartile of serum phosphorus level (4.0 mg/dL or less), those in the fourth quartile (5.6 mg/dL or greater) had a 2.8 times increased risk of hemorrhagic stroke in adjusted analyses. Each 1 mg/dL increase in serum phosphorus was associated with a significant 26% increased risk of hemorrhagic stroke. Hyperphosphatemia did not increase the risk of cerebral infarction.

During a mean observational period of 3.9 years, cerebral hemorrhage and cerebral infarction occurred in 77 patients and 140 patients, respectively.

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The researchers concluded that their findings highlight the importance of phosphate management in the prevention of cerebral hemorrhage in dialysis patients.