|The following article is part of conference coverage from Kidney Week 2017 in New Orleans hosted by the American Society of Nephrology. Renal & Urology News staff will be reporting live on medical studies conducted by nephrologists and other specialists who are tops in their field in acute kidney injury, chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from Kidney Week 2017.|
NEW ORLEANS—Hospitalized patients with low and high serum phosphate levels are at elevated risk for dying in the hospital, according to study findings presented at the American Society of Nephrology’s Kidney Week 2017 meeting.
In a study of 42,336 hospitalized patients at Mayo Clinic in Rochester, Minnesota, lead authors Michael A. Mao, MD, and Wisit Cheungpasitporn and collaborators found a greater likelihood of in-hospital mortality among patients with admission serum phosphate levels below 2.5 and above 4.2 mg/dL. Compared with patients who had admission serum phosphate levels of 3.1 to 3.6 mg/dL (reference group), patients who had levels below 2.5 and 4.9 mg/dL or higher had 1.6-fold and 3.9-fold greater odds of in-hospital mortality, respectively, after adjusting for potential confounders.
Among patients with an admission serum phosphate level of 4.9 mg/dL or above, in-hospital mortality risk was greater among patients with versus without chronic kidney disease (CKD) and those with versus without cardiovascular disease (CVD). Patients with CKD had 4-fold greater odds of in-hospital mortality compared with the reference group, whereas those without CKD had 3-fold greater odds. Patients with CVD had 5-fold greater odds of in-hospital mortality, whereas those without CVD had 3-fold greater odds.
“The beneficial data on the use of phosphate binders in the general hospitalized patients with hyperphosphatemia are limited,” Dr Cheungpasitporn told Renal & Urology News. “In addition, although phosphate replacement for hypophosphatemia is suggested to be safe, there is a paucity of evidence whether correction of hypophosphatemia can improve clinical outcomes. Whether these interventions improve in-hospital mortality in patients with hyperphosphatemia or hypophosphatemia at hospital admission requires future studies, ideally with randomized controlled trials.”
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Mao MA, Cheungpasitporn W, Thongprayoon C, et al. Impact of admission serum phosphate levels on mortality in hospitalized patients. Data presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31-Nov. 5). Abstract TH-PO1049.