Phosphate binder use was associated with lower mortality riskbut a higher risk of end-stage renal disease (ESRD) among patients withchronic kidney disease (CKD) andhigh phosphorus levels, accordingto study findings presented at theNational Kidney Foundation’s 2015Spring Clinical Meetings in Dallas.
In a retrospective longitudinal cohortstudy, Ardeshir Khosraviani, MD, andcolleagues at Kaiser PermanenteSouthern California compared phosphatebinder use and non-use among3,026 non-dialysis CKD patients withhyperphosphatemia (phosphorus levels5.5 mg/dL or higher). Comparedwith patients who did not use phosphatebinders, those who did had a15% decreased mortality risk and anearly 3-fold increased risk of ESRD,the investigators reported.
“These findings underscore theneed to better understand whetherearlier phosphorus management mayimpact morbidity and mortality inadvanced CKD,” the authors concludedin a poster presentation.Of the 3,026 subjects, 596 usedbinders and 2,430 did not. Studysubjects had a mean age was 65.5years; 49% were female, 49% werewhite, 24% were Hispanic, 17.3%were black, and 8.5% were Asian.The binder group had higher rates ofdiabetes, hypertension, and coronary artery disease.
“Our study raises the question ofwhether earlier management andcontrol of hyperphosphatemia in theCKD population with binder therapymay improve patient survival interms of mortality prior to and after[transition to ESRD],” Dr. Khosravianitold Renal & Urology News.
He said he and his colleaguesbelieve their study adds to the literatureon the topic because it lookedat a real-world practice environmentusing a large and heterogeneousCKD population, and the results provideinsights into CKD mineral-bonemanagement strategies as patientstransition to ESRD.