title: Phosphorus as an early marker of morbidity and mortality in type 2 chronic kidney disease diabetic patients.
abstract: OBJECTIVE
  To evaluate the association of different phosphorus levels with cardiovascular mortality and hospitalizations risk in type-2 diabetic patients in phase 3/4 of CKD.
  
  
  METHODS
  An observational, prospective study involving 119 patients divided into groups according to baseline phosphorus levels: 1, ≤3.60 mg/dL; 2, 3.60-4.60 mg/dL; and 3, >4.60 mg/dL. Baseline characteristics were analyzed and compared. Multivariate Cox regression and Multivariate Logistic regression were used to find out the predictors of cardiovascular mortality and hospitalizations, respectively. T-test was used to investigate the association of phosphorus and start of hemodialysis.
  
  
  RESULTS
  Patients of group 3 presented lower clearance and Hb and increased PTH, Ca×P, LVMI, HOMA, uric acid, IL-6 and more hospitalization days. Patients' mean survival on groups 1, 2 and 3 was 62.5 ± 1.95, 60.1 ± 2.85 and 52.6 ± 2.84 months, respectively (p = 0.001). Phosphorus and creatinine levels were independent predictors of mortality, and phosphorus, creatinine, PTH and age were independent predictors of hospitalizations in this population. Patients who entered hemodialysis presented greater phosphorus levels than those who did not (5.04 ± 1.31 vs. 4.14 ± 1.09; p = 0.001).
  
  
  CONCLUSIONS
  Phosphorus was a predictor of cardiovascular mortality and hospitalizations. Phosphorus levels might have a significant clinical use, possibly translated as an early marker of mortality and hospitalizations in this population.
authors.affiliation: Nephrology, Hospital Faro, Faro, Portugal. anapassionara@gmail.com
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Silva
authors.forename: André
authors.initials: A
authors.lastname: Fragoso
authors.forename: Ana
authors.initials: A
authors.lastname: Pinho
authors.forename: Nelson
authors.initials: N
authors.lastname: Tavares
authors.forename: Ana
authors.initials: A
authors.lastname: Camacho
authors.forename: Marília
authors.initials: M
authors.lastname: Faísca
authors.forename: Pedro
authors.initials: P
authors.lastname: Leão Neves
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D003928:Diabetic Nephropathies / Q000175:diagnosis* / Q000401:mortality; D042241:Early Diagnosis; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality; D010758:Phosphorus / Q000097:blood*; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality
chemical_list: D015415:Biomarkers; D010758:Phosphorus