Serum phosphate is associated with left ventricular mass in patients with chronic kidney disease: a cardiac magnetic resonance study.
OBJECTIVE
To explore the relationship between serum phosphate, arterial stiffness and left ventricular mass (LVM) in patients with early-stage chronic kidney disease (CKD).


METHODS
A cross-sectional observational study.


METHODS
Single centre.


METHODS
208 patients with stage 2 to stage 4 non-diabetic CKD.


METHODS
Arterial stiffness was determined through measurement of aortic pulse wave velocity (PWV). Cardiac magnetic resonance was used to determine LVM.


METHODS
Relationship between serum phosphate, aortic PWV and LVM.


RESULTS
Mean age was 54 ± 13 years, mean glomerular filtration rate was 50 ± 15 ml/min/1.73 m(2), mean serum phosphate was 1.11 ± 0.21 mmol/l and mean PWV was 8.6 ± 2.1 m/s. When the cohort was divided into quartiles according to serum phosphate, LVM increased across quartiles (p=0.04), with no significant differences in age, kidney function, blood pressure or PWV. Serum phosphate correlated with LVM (r=0.173; p=0.01), but PWV did not (p=0.2). In a regression model containing gender, serum phosphate, office systolic blood pressure, albumin/creatinine ratio and haemoglobin, 30% of the variation in LVM was explained (p<0.0005), with serum phosphate accounting for 5% of the variance.


CONCLUSIONS
Serum phosphate is independently associated with LVM in patients with CKD. Interventional studies are required to determine whether this association is causative and whether reducing phosphate exposure reduces LVM in this population.
Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, UK.
Colin D
CD
Chue
Nicola C
NC
Edwards
William E
WE
Moody
Richard P
RP
Steeds
Jonathan N
JN
Townend
Charles J
CJ
Ferro
D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood*; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016277:Ventricular Function, Left / Q000502:physiology*
D015415:Biomarkers; D010710:Phosphates