DENVER—High baseline serum phosphorus levels in CKD patients may predict an increased likelihood of renal disease progression and death, according to Italian investigators.

Antonio Ballasi, MD, and colleagues at Policlinico S. Orsola-Malpighi in Bologna studied 1,716 patients with CKD stages 3-5. They examined the association between baseline serum phosphorus and the risk of a composite outcome of dialysis initiation and death. Investigators followed patients for up to four years.

Elevated serum phosphorus was significantly associated with diabetes and inversely associated with glomerular filtration rate, age, and male gender. The researchers observed a graded increase in the risk of the composite outcome across quartiles of serum phosphorus. This association remained significant even after adjusting for traditional cardiovascular risk factors and CKD stage, the authors reported in their poster presentation.

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Patients in the highest phosphorus quartile (above 4.3 mg/dL) had a significant twofold increased risk of the composite endpoint compared with patients with serum phosphorus levels of 3.3-3.8 mg/dL

“These analyses lend support to the hypothesis that serum phosphorus levels at baseline might accelerate residual renal function deterioration and increase the risk of death in patients with mild to moderate renal function impairment,” the researchers concluded.