People with any stage of CKD have an increased risk of developing heart disease or a stroke. Severity can vary but most cases are mild or moderate, occur in older people, do not cause symptoms and do not progress to kidney failure. Providers must communicate tough messages—from giving a kidney disease diagnosis to discussing renal replacement therapy options—that can be difficult both for the patient to hear and for the provider to deliver.
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.
kidneyhospitalabroad@hotmail.com
www.kidneyhospitalabroad.com/ckd/
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.
kidneyhospitalabroad@hotmail.com
www.kidneyhospitalabroad.com/ckd/
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