Higher Phosphorus, Cardiovascular Disease (CVD) Not Linked in Kidney Disease (CKD) Patients

The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases. Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys and heart, as well as blood vessels, nerves and eyes. High blood pressure, or hypertension, occurs when the pressure of your blood against the walls of your blood vessels increases. If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.

Using data from the Kaiser Permanente Southern California database, Dean Kujubu, MD, and colleagues at the Department of Nephrology & Hypertension at Kaiser Permanente Los Angeles Medical Center conducted a cross-sectional study of 195,097 patients across various estimated glomerular filtration rate (eGFR ranges (90 or higher, 60-89, 30-59, and less than 30 mL/min/1.73 m2) from January 1999 to December 2009.

The study excluded patients who were on dialysis or who had kidney transplants. The primary outcome was a composite of coronary artery disease (CAD), congestive heart failure (CHF), and cerebrovascular accident (CVA).

Overall, each 0.5 mg/dL increment in serum phosphorus was not associated with the primary outcome, but it was associated with a 58% increased odds of CHF.

Among patients with an eGFR of greater than 89 mL/min/1.73 m2, each 0.5 mg/dL increase in serum phosphorus was associated with 23% increased odds for the composite endpoint.

“In a large, diverse population, we did not observe increased risk of prevalent CAD, CHF, and CVA with higher serum phosphorus levels among individuals with eGFR of less than 89 ml/min,” the authors concluded.