title: Serum phosphate and outcome at one year after deceased donor renal transplantation.
abstract: Traditional risk factors do not adequately explain the increased prevalence of cardiovascular disease in renal patients. This study considered a "non-traditional" risk factor, serum phosphate and outcome in renal transplant recipients. Data from 377 patients who received a first deceased donor renal transplant between January 1, 1999, and December 31, 2008, were recorded; 10% (n=38) had diabetes, 16.7% (n=63) were smokers, and 18.8% (n=71) had a history of vascular disease. Three hundred and thirty-three patients were alive at the time of the analysis. Survivors were significantly younger, less likely to be smokers or diabetic, and had a higher estimated glomerular filtration rate at one yr post-transplantation. Serum phosphate was significantly lower in these patients (0.95 ± 0.23 vs. 1.04 ± 0.26, p = 0.031). Analysis of recipient survival, stratified by serum phosphate at one yr post-transplant, revealed that serum phosphate > 1.11 mMol/L was a significant predictor of all-cause mortality (p=0.006). Serum phosphate between 0.9 and 1.11 mMol/L afforded the best outcome. In multivariate analysis, serum phosphate remained a significant predictor of mortality (p=0.016). Serum phosphate at one yr after transplant seems to have a J-shaped relationship with mortality, and this effect is independent of traditional cardiovascular risk factors.
authors.affiliation: BHF, Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK. kate.stevens@Glasgow.ac.uk
authors.forename: K K
authors.initials: KK
authors.lastname: Stevens
authors.forename: I R
authors.initials: IR
authors.lastname: Morgan
authors.forename: R K
authors.initials: RK
authors.lastname: Patel
authors.forename: C C
authors.initials: CC
authors.lastname: Geddes
authors.forename: P B
authors.initials: PB
authors.lastname: Mark
authors.forename: A G
authors.initials: AG
authors.lastname: Jardine
authors.forename: C
authors.initials: C
authors.lastname: Delles
mesh_terms: D002102:Cadaver; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood*; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D010710:Phosphates