Association between serum phosphorus and mortality in NHANES 2003¿2006: the effect of gender and renal function

• Type: Article in International Scientific Journal
• Date: 2022

Authors

Mendonça L. (Author) Other; Gonçalves F. (Author) Other; Sampaio S. (Author) FMUP; Castro-Chaves P (Author) FMUP; Pereira L. (Author) Other

Journal

Title: Journal of Nephrology

Vol. 35

Pages: 165-178

ISSN: 1121-8428

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 3 Citations

Scopus - 2 Citations

Other information

Authenticus ID: P-00V-ZSD

DOI: 10.1007/s40620-021-00969-4

Abstract (EN): Background: The impact of high serum phosphorus in the general population is still debated. Studies are heterogeneous, most lack an adjustment for parathyroid hormone, vitamin D and phosphorus intake and the effect might differ by gender and renal function. We investigated the association between serum phosphorus and mortality in American adults. Methods: We prospectively analyzed 5698 non-pregnant and non-CKD adults from the National Health and Nutrition Examination Survey (NHANES) 2003¿2006. Serum phosphorus and potential confounders including parathyroid hormone, 25(OH)vitamin D and phosphorus intake were evaluated. All-cause, cardiovascular- and cancer-related deaths were recorded through December 31st, 2015. Sex-specific terciles of serum phosphorus were used to fit adjusted Cox proportional hazard models for mortality. Analysis was stratified by gender and renal function. Results: A total of 590 deaths were recorded over a median follow-up of 81 months. Women showed higher serum phosphorus than men. The adjusted hazard ratio (HR) for all-cause mortality was 1.35 (95% CI 1.08¿1.58) (p = 0.033) for the third tercile (versus second tercile). This increased risk was present in participants with estimated glomerular filtration rate (eGFR) below 90 ml/min/1.73 m2 but not above, although interaction was not significant (p = 0.12). Interaction by gender, phosphorus intake, PTH and fasting time was also not detected. For cardiovascular and cancer mortality, the adjusted HR was 0.81 (95% CI 0.33¿2.00) (p = NS) and 1.45 (95% CI 0.77¿2.72) (p = NS), respectively. Conclusions: We demonstrated that the highest tercile of serum phosphorus is associated with increased all-cause mortality, irrespective of PTH, 25(OH)vitamin D or phosphorus intake. This association may differ by gender and renal function, but larger studies testing for effect modification are needed. Graphic abstract: [Figure not available: see fulltext.]

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 13