|Serum Phosphorus and Progression of CKD and Mortality: A Meta-analysis of Cohort Studies|
|Da, Jingjing1,2,3,4,5,6; Xie, Xinfang1,2,3,4; Wolf, Myles7; Disthabanchong, Sinee8; Wang, Jinwei1,2,3,4; Zha, Yan5,6; Lv, Jicheng1,2,3,4; Zhang, Luxia1,2,3,4; Wang, Haiyan1,2,3,4|
|关键词||Serum phosphorus phosphorus homeostasis kidney failure renal outcome mortality chronic kidney disease (CKD) non-dialysis-dependent CKD disease progression disease trajectory prognosis meta-analysis|
|刊名||AMERICAN JOURNAL OF KIDNEY DISEASES|
|WOS标题词||Science & Technology|
|类目[WOS]||Urology & Nephrology|
|研究领域[WOS]||Urology & Nephrology|
|关键词[WOS]||CHRONIC KIDNEY-DISEASE ; RENIN-ANGIOTENSIN SYSTEM ; MINERAL METABOLISM ; INDEPENDENT ASSOCIATION ; 25-HYDROXYVITAMIN D ; ACE-INHIBITION ; RISK-FACTORS ; PHOSPHATE ; CALCIUM ; OUTCOMES|
Background: Recent studies have indicated that phosphorus may play an independent pathogenic role in chronic kidney disease (CKD) progression, but some of those studies were underpowered and yielded inconsistent results.
Study Design: Systematic review and meta-analysis.
Setting & Population: Non-dialysis-dependent patients with CKD (transplant recipients were excluded).
Selection Criteria for Studies: Studies assessing the risk ratio of serum phosphorus level on kidney failure and mortality for non-dialysis-dependent patients with CKD published from January 1950 to June 2014 were included following systematic searching of MEDLINE, EMBASE, and the Cochrane Library.
Predictor: Serum phosphorus level.
Outcome: Kidney failure, defined as doubled serum creatinine level, 50% decline in estimated glomerular filtration rate, or end-stage kidney disease.
Results: In 12 cohort studies with 25,546 patients, 1,442 (8.8%) developed kidney failure and 3,089 (13.6%) died. Overall, every 1-mg/dL increase in serum phosphorus level was associated independently with increased risk of kidney failure (hazard ratio, 1.36; 95% CI, 1.20-1.55) and mortality (hazard ratio, 1.20; 95% CI, 1.05-1.37).
Limitations: Existence of potential residual confounding could not be excluded.
Conclusions: This meta-analysis suggests an independent association between serum phosphorus level and kidney failure and mortality among non-dialysis-dependent patients with CKD and suggests that large-scale randomized controlled trials should target disordered phosphorus homeostasis in CKD. (C) 2015 by the National Kidney Foundation, Inc.
|项目编号||201002010 ; 2011BAI10B01 ; D131100004713007|
|资助机构||Research Special Fund for Public Welfare Industry of Health from National Health and Family Planning Commission of the People&prime ; s Republic of China ; National Key Technology R& ; D Program of the Ministry of Science and Technology ; Establishment of Early Diagnosis Pathway and Model for Evaluating Progression of Chronic Kidney Disease from the Beijing Science and Technology Committee|
|作者单位||1.Peking Univ, Hosp 1, Div Renal, Dept Med, Beijing 100871, Peoples R China|
2.Peking Univ, Inst Nephrol, Beijing 100871, Peoples R China
3.Peking Univ, Minist Educ, Key Lab Renal Dis, Beijing 100871, Peoples R China
4.Peking Univ, Key Lab Chron Kidney Dis Prevent & Treatment, Minist Educ, Beijing 100871, Peoples R China
5.Guizhou Prov Peoples Hosp, Div Renal, Dept Med, Guiyang, Guizhou, Peoples R China
6.Guizhou Prov Inst Nephrit & Urinary Dis, Guiyang, Guizhou, Peoples R China
7.Univ Miami, Miller Sch Med, Div Nephrol & Hypertens, Dept Med,Div Biostat,Dept Epidemiol & Publ Hlth, Miami, FL 33136 USA
8.Mahidol Univ, Div Nephrol, Ramathibodi Hosp, Dept Med,Fac Med, Bangkok 10700, Thailand
|Da, Jingjing,Xie, Xinfang,Wolf, Myles,et al. Serum Phosphorus and Progression of CKD and Mortality: A Meta-analysis of Cohort Studies[J]. AMERICAN JOURNAL OF KIDNEY DISEASES,2015,66(2):258-265.|
|APA||Da, Jingjing.,Xie, Xinfang.,Wolf, Myles.,Disthabanchong, Sinee.,Wang, Jinwei.,...&Wang, Haiyan.(2015).Serum Phosphorus and Progression of CKD and Mortality: A Meta-analysis of Cohort Studies.AMERICAN JOURNAL OF KIDNEY DISEASES,66(2),258-265.|
|MLA||Da, Jingjing,et al."Serum Phosphorus and Progression of CKD and Mortality: A Meta-analysis of Cohort Studies".AMERICAN JOURNAL OF KIDNEY DISEASES 66.2(2015):258-265.|