Meta-Analysis of Serum Phosphorus, Progression and Mortality in CKD Patients

Meta-Analysis of Serum Phosphorus, Progression and Mortality in CKD Patients

Results from a meta-analysis published in the American Journal of Kidney Diseases indicate there is an independent association between serum phosphorus level, kidney failure and mortality among non–dialysis-dependent patients suffering from chronic kidney disease (CKD).

CDK includes all the conditions that damage the kidneys and decrease their ability to keep the body healthy. If kidney disease progresses, wastes can build to high levels in the blood, causing complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases the risk of developing heart and blood vessel diseases.

These problems may progress slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders, and early detection and treatment can often keep it from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a transplant to keep patients alive.

Recent estimates indicate that more than 10% of adults in the United States—more than 20 million people— may have CKD of varying levels of seriousness. The chances of being diagnosed with CKD increase with age: it increases after 50 years of age and is most common among adults older than 70 years.

Imbalances of  phosphorus have been found to result in a number of serious clinical complications, including arrhythmias, seizures, and respiratory difficulties. The kidney plays a critical role in regulating serum levels of these ions.

Using the databases MEDLINE, EMBASE, and the Cochrane Library, in the study titled “Serum Phosphorus and Progression of CKD and Mortality: A Meta-analysis of Cohort Studies”, Luxia Zhang, MD, MPH, Renal Division, Peking University First Hospital in Beijing China and colleagues examined all studies conducted between January 1950 and June 2014 looking at the risk ratio of serum phosphorus levels on kidney failure and mortality for non–dialysis-dependent patients with CKD.

A total of 12 studies involving a population of 25,546 CDK patients were included in the analysis. Of these, the results showed that 1,442 (8.8%) developed kidney failure and 3,089 (13.6%) died. Overall, every 1-mg/dL increase in serum phosphorus level was independently associated with an increased risk of kidney failure and mortality.

The authors indicate the need for large-scale randomized controlled trials targeting disordered phosphorus homeostasis in patients with CKD.

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Daniela holds a PhD in Clinical Psychology from The University of Edinburgh, United Kingdom, a MSc in Health Psychology and a BSc in Clinical Psychology. Her work has been focused on vulnerability to psychopathology and early identification and intervention in psychosis.

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