Longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients: a multicenter retrospective cohort study
Abstract Background Relationship between serum phosphorus time in range and mortality risk in peritoneal dialysis (PD) patients remains uncertain. We aimed to evaluate the association between serum phosphorus time in range and all-cause mortality in Chinese PD population. Methods This was a multicen...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-023-03395-9 |
| _version_ | 1827301355024285696 |
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| author | Zhihao Huo Dehui Liu Peiyi Ye Yuehang Zhang Lisha Cao Nirong Gong Xianrui Dou Chengfa Ren Qingyao Zhu Dan Li Wei Zhang Yaozhong Kong Guobao Wang Jun Ai |
| author_facet | Zhihao Huo Dehui Liu Peiyi Ye Yuehang Zhang Lisha Cao Nirong Gong Xianrui Dou Chengfa Ren Qingyao Zhu Dan Li Wei Zhang Yaozhong Kong Guobao Wang Jun Ai |
| author_sort | Zhihao Huo |
| collection | DOAJ |
| description | Abstract Background Relationship between serum phosphorus time in range and mortality risk in peritoneal dialysis (PD) patients remains uncertain. We aimed to evaluate the association between serum phosphorus time in range and all-cause mortality in Chinese PD population. Methods This was a multicenter, retrospective, cohort study of 1,915 patients collected from January 2008 to October 2020 in 4 Chinese centers. Serum phosphorus time in range was estimated as the months during the first year that a patient’s serum phosphorus level was within the target range (defined as 1.13–1.78 mmol/L). The primary outcome was all-cause mortality. The secondary outcomes were cardiovascular (CV) mortality and PD withdrawal. Cox proportional hazards regression model with comprehensive adjustments was used to assess the association. Results The primary outcome occurred in 249 (13.0%) PD patients over a median follow-up of 28 months. Overall, the serum phosphorus time in range was negatively associated with all-cause mortality (per 3-month increments, adjusted HR [aHR], 0.83; 95%CI: 0.75–0.92), CV mortality (per 3-month increments, aHR, 0.87; 95%CI: 0.77–0.99), and PD withdrawal (per 3-month increments, aHR, 0.89; 95%CI: 0.83–0.95). Competing-risk model showed that the relationship of serum phosphorus time in range with all-cause mortality remained stable. None of the variables including demographics, history of diabetes and CV disease, as well as several PD-related and clinical indicators modified this association. Conclusions PD patients with longer serum phosphorus time in range in the first year was negatively associated with all-cause mortality and CV mortality. Our findings highlight the importance of maintaining serum phosphorus levels within 1.13–1.78 mmol/L for PD patients. |
| first_indexed | 2024-04-24T16:21:44Z |
| format | Article |
| id | doaj.art-de01afa44d41457f970c406bf14f81ba |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-24T16:21:44Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-de01afa44d41457f970c406bf14f81ba2024-03-31T11:12:41ZengBMCBMC Nephrology1471-23692024-03-012511910.1186/s12882-023-03395-9Longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients: a multicenter retrospective cohort studyZhihao Huo0Dehui Liu1Peiyi Ye2Yuehang Zhang3Lisha Cao4Nirong Gong5Xianrui Dou6Chengfa Ren7Qingyao Zhu8Dan Li9Wei Zhang10Yaozhong Kong11Guobao Wang12Jun Ai13Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure ResearchDepartment of Nephrology, Nanfang Hospital, Ganzhou (Ganzhou People’s Hospital)Nephrology Department, The First People’s Hospital of FoshanDivision of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure ResearchDivision of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure ResearchDivision of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure ResearchDepartment of Nephrology, Shunde Hospital, Southern Medical UniversityDepartment of Nephrology, Nanfang Hospital, Ganzhou (Ganzhou People’s Hospital)Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure ResearchDivision of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure ResearchDepartment of Nephrology, Shunde Hospital, Southern Medical UniversityNephrology Department, The First People’s Hospital of FoshanDivision of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure ResearchDivision of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure ResearchAbstract Background Relationship between serum phosphorus time in range and mortality risk in peritoneal dialysis (PD) patients remains uncertain. We aimed to evaluate the association between serum phosphorus time in range and all-cause mortality in Chinese PD population. Methods This was a multicenter, retrospective, cohort study of 1,915 patients collected from January 2008 to October 2020 in 4 Chinese centers. Serum phosphorus time in range was estimated as the months during the first year that a patient’s serum phosphorus level was within the target range (defined as 1.13–1.78 mmol/L). The primary outcome was all-cause mortality. The secondary outcomes were cardiovascular (CV) mortality and PD withdrawal. Cox proportional hazards regression model with comprehensive adjustments was used to assess the association. Results The primary outcome occurred in 249 (13.0%) PD patients over a median follow-up of 28 months. Overall, the serum phosphorus time in range was negatively associated with all-cause mortality (per 3-month increments, adjusted HR [aHR], 0.83; 95%CI: 0.75–0.92), CV mortality (per 3-month increments, aHR, 0.87; 95%CI: 0.77–0.99), and PD withdrawal (per 3-month increments, aHR, 0.89; 95%CI: 0.83–0.95). Competing-risk model showed that the relationship of serum phosphorus time in range with all-cause mortality remained stable. None of the variables including demographics, history of diabetes and CV disease, as well as several PD-related and clinical indicators modified this association. Conclusions PD patients with longer serum phosphorus time in range in the first year was negatively associated with all-cause mortality and CV mortality. Our findings highlight the importance of maintaining serum phosphorus levels within 1.13–1.78 mmol/L for PD patients.https://doi.org/10.1186/s12882-023-03395-9Peritoneal dialysisSerum phosphorusTime in rangeAll-cause mortalityCardiovascular mortalityPeritoneal dialysis withdrawal |
| spellingShingle | Zhihao Huo Dehui Liu Peiyi Ye Yuehang Zhang Lisha Cao Nirong Gong Xianrui Dou Chengfa Ren Qingyao Zhu Dan Li Wei Zhang Yaozhong Kong Guobao Wang Jun Ai Longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients: a multicenter retrospective cohort study BMC Nephrology Peritoneal dialysis Serum phosphorus Time in range All-cause mortality Cardiovascular mortality Peritoneal dialysis withdrawal |
| title | Longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients: a multicenter retrospective cohort study |
| title_full | Longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients: a multicenter retrospective cohort study |
| title_fullStr | Longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients: a multicenter retrospective cohort study |
| title_full_unstemmed | Longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients: a multicenter retrospective cohort study |
| title_short | Longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients: a multicenter retrospective cohort study |
| title_sort | longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients a multicenter retrospective cohort study |
| topic | Peritoneal dialysis Serum phosphorus Time in range All-cause mortality Cardiovascular mortality Peritoneal dialysis withdrawal |
| url | https://doi.org/10.1186/s12882-023-03395-9 |
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