Serum phosphorus concentrations and arterial stiffness among individuals with normal kidney function to moderate kidney disease in MESA.
OBJECTIVE
Higher phosphorus levels are associated with cardiovascular disease (CVD) events and mortality. Whether vascular stiffness may be responsible is unknown.


METHODS
This study examined the cross-sectional associations of serum phosphorus with ankle brachial index (ABI), pulse pressure, and large and small artery elasticity by radial artery waveform analysis among 1370 individuals (440 with moderate chronic kidney disease) who did not have clinical CVD and participated in the Multi-Ethnic Study of Atherosclerosis.


RESULTS
Fifty-nine (4%) individuals had high ABI (>1.30), a marker of peripheral arterial stiffness. Participants with phosphorus levels >4 mg/dl had greater than four-fold risk for high ABI compared with participants with phosphate levels <3 mg/dl (relative risk 4.6; 95% confidence interval 1.6 to 13.2; P = 0.01) after adjustment for demographics, traditional CVD risk factors, and kidney function. Higher phosphorus levels were also associated with greater pulse pressure and lesser large and small artery elasticity in unadjusted models, but these associations were attenuated after adjustment.


CONCLUSIONS
Higher phosphorus levels are strongly associated with high ABI but not pulse pressure or large or small artery elasticity. If confirmed in future studies, then the association of higher phosphorus concentrations with CVD events may be partially mediated through peripheral arterial stiffness.
Ix
Joachim H
JH
Department of Medicine, Division of Nephrology and Hypertension, University of California San Diego, San Diego, CA 92161, USA. joeix@ucsd.edu
De Boer
Ian H
IH
Peralta
Carmen A
CA
Adeney
Kathryn L
KL
Duprez
Daniel A
DA
Jenny
Nancy S
NS
Siscovick
David S
DS
Kestenbaum
Bryan R
BR
D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000098:blood supply; D001158:Arteries / Q000503:physiopathology*; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004548:Elasticity; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D010758:Phosphorus / Q000097:blood*; D011673:Pulsatile Flow; D017534:Radial Artery / Q000503:physiopathology; D014481:United States; D015854:Up-Regulation
D010758:Phosphorus