Serum Phosphorus and Cardiovascular Disease Outcomes, Graft Failure, or Total Mortality in Chronic Kidney Transplant Recipients.
1Medicine, Rhode Island Hospital, Chepachet, RI
2Gerontology, Brown Uinversity, Chepachet, RI
3Public Health, UNC, Chapel Hill, NC
4NIDDK, National Institutes of Health, Bethesda, MD
5Nutritional Epidemiology, Tufts Human Nutrition Research Center, Boston, MA
6Medicine, Brigham and Women's Hospital, Boston, MA
7Medicine, Tufts New England Medical Center, Boston, MA
8Medicine, Toronto General Hospital, Toronto, ON, Canada
9Medicine, Veterans Administration Medical Center, San Diego, CA
Meeting: 2017 American Transplant Congress
Abstract number: D150
Keywords: Arteriosclerosis, Kidney transplantation, Renal failure, Renal function
Session Information
Session Name: Poster Session D: Kidney: Cardiovascular and Metabolic
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Mild hyperphosphatemia may be present in chronic kidney transplant recipients [KTRs]. Limited data are available from large, multicenter KTR cohorts assessing the potential relationships between serum phosphorus levels, & the development of cardiovascular disease (CVD) outcomes, graft failure, or all-cause death, among chronic, stable KTRs. Serum phosphorus [P] was determined in n= 3,181 FAVORIT trial [NCT00064753] participants at randomization (mean P=3.07±0.68, range 0.79-8.32 mg/dl). During a median follow-up of 4.0-years, the cohort experienced n=445 CVD outcomes, 351 deaths, & 242 graft failures (return to dialysis). Proportional hazards modeling revealed that each 1 mg/dl higher of serum P was not associated with a significant increase in CVD risk [HR=1.06, 95% CI 0.92-1.22], but did increase graft failure [HR=1.38, 95% CI 1.16-1.64], & total mortality risk [HR=1.20, 95% CI 1.03-1.40], when adjusted for age, baseline CVD, diabetes, smoking, race, sex, body-mass index, LDL, HDL, triglycerides, estimated glomerular filtration rate [eGFR], urinary albumin/creatinine [UA/Cr], type of kidney graft, graft vintage, & use of calcineurin inhibitors, steroids, or lipid lowering drugs. More parsimonious modeling (without eGFR, or UA/Cr) strengthened these associations: CVD [HR=1.15, 95% CI 1.00-1.32]; graft failure [HR=1.83, 95% CI 1.54-2.18]; mortality [HR=1.34, 95% CI 1.15-1.56]. Comparable findings resulted when such models were restricted to those with an eGFR of 15-44 ml/min/1.73m2 (n=1,453): CVD [HR=1.15, 95% CI 0.96-1.37]; graft failure [HR=1.65, 95% CI 1.36-2.01]; mortality [HR=1.21, 95% CI 1.00-1.47]. Serum phosphorus is marginally associated with CVD, & more strongly associated with graft failure, or total mortality in chronic KTRs. Adjustment for eGFR & UA/Cr attenuates these associations.
CITATION INFORMATION: Merhi B, Shireman T, Carpenter M, Kusek J, Jacques P, Pfeffer M, Levey A, Rao M, Kim J, Ix J, Bostom A. Serum Phosphorus and Cardiovascular Disease Outcomes, Graft Failure, or Total Mortality in Chronic Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Merhi B, Shireman T, Carpenter M, Kusek J, Jacques P, Pfeffer M, Levey A, Rao M, Kim J, Ix J, Bostom A. Serum Phosphorus and Cardiovascular Disease Outcomes, Graft Failure, or Total Mortality in Chronic Kidney Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/serum-phosphorus-and-cardiovascular-disease-outcomes-graft-failure-or-total-mortality-in-chronic-kidney-transplant-recipients/. Accessed November 21, 2024.« Back to 2017 American Transplant Congress