title: Association of serum phosphorus variability with coronary artery calcification among hemodialysis patients.
abstract: Coronary artery calcification (CAC) is associated with increased mortality in patients on maintenance hemodialysis (MHD), but the pathogenesis of this condition is not well understood. We evaluated the relationship of CAC score (CACs) and variability in serum phosphorus in MHD patients. Seventy-seven adults on MHD at Huashan Hospital (Shanghai) were enrolled in July, 2010. CAC of all the patients were measured by computed tomography and CACs was calculated by the Agatston method at the entry of enrollment. Patients were divided into three categories according to their CACs (0∼10, 11∼400, and >400). Blood chemistry was recorded every 3 months from January 2008 to July 2010. Phosphorus variation was defined by the standard deviation (SD) or coefficient of variation (CV) and it was calculated from the past records. The ordinal multivariate logistic regression analysis was used to analyze the predictors of CAC. The mean patient age (± SD) was 61.7 years (±11.3) and 51% of patients were men. The mean CACs was 609.6 (±1062.9), the median CACs was 168.5, and 78% of patients had CACs more than 0. Multivariate analysis indicated that female gender (OR = 0.20, 95% CI = 0.07-0.55), age (OR = 2.31, 95% CI = 1.32-4.04), serum fibroblast growth factor 23 (OR = 2.25, 95% CI = 1.31-3.85), SD-phosphorus calculated from the most recent 6 measurements (OR = 2.12; 95% CI = 1.23-3.63), and CV-phosphorus calculated from the most recent 6 measurements (OR = 1.90, 95% CI = 1.16-3.11) were significantly and independently associated with CACs. These associations persisted for phosphorus variation calculated from past 7, 8, 9, 10, and 11 follow-up values. Variability of serum phosphorus may contribute significantly to CAC and keeping serum phosphorus stable may decrease coronary calcification and associated morbidity and mortality in MHD patients.
authors.affiliation: Division of Nephrology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Mengjing
authors.initials: M
authors.lastname: Wang
authors.affiliation: Division of Nephrology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Haiming
authors.initials: H
authors.lastname: Li
authors.affiliation: Division of Nephrology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Li
authors.initials: L
authors.lastname: You
authors.affiliation: Division of Nephrology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Yu
authors.affiliation: Division of Nephrology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Division of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Ruijiang
authors.initials: R
authors.lastname: Zhu
authors.affiliation: Division of Nephrology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Chuanming
authors.initials: C
authors.lastname: Hao
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, China; Biomedical statistical Center, Fudan University, Shanghai, China.
authors.forename: Zhijie
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Division of Nephrology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000097:blood*; D002118:Calcium / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood*; D006435:Renal Dialysis; D012307:Risk Factors
chemical_list: D010281:Parathyroid Hormone; D010758:Phosphorus; D002118:Calcium
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