Serum Phosphorus and Albumin in Patients Undergoing Peritoneal Dialysis: Interaction and Association With Mortality

Hyperphosphatemia and hypoalbuminemia confer worse clinical outcomes, whether these risk factors interact to predispose to mortality is unclear. In this prospective cohort study, 2,118 patients undergoing incident continuous ambulatory peritoneal dialysis (CAPD) were enrolled and categorized into fo...

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Autores principales:	Naya Huang, Huiyan Li, Li Fan, Qian Zhou, Dongying Fu, Lin Guo, Chunyan Yi, Xueqing Yu, Haiping Mao
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	serum phosphorus albumin peritoneal dialysis interaction mortality Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/be8e1d95d1ee407baf0ba10f43a24976
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spelling	oai:doaj.org-article:be8e1d95d1ee407baf0ba10f43a249762021-12-02T00:25:09ZSerum Phosphorus and Albumin in Patients Undergoing Peritoneal Dialysis: Interaction and Association With Mortality2296-858X10.3389/fmed.2021.760394https://doaj.org/article/be8e1d95d1ee407baf0ba10f43a249762021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.760394/fullhttps://doaj.org/toc/2296-858XHyperphosphatemia and hypoalbuminemia confer worse clinical outcomes, whether these risk factors interact to predispose to mortality is unclear. In this prospective cohort study, 2,118 patients undergoing incident continuous ambulatory peritoneal dialysis (CAPD) were enrolled and categorized into four groups based on the changing point regarding mortality at 1.5 mmol/L for serum phosphorus and 35 g/L for serum albumin. Risks of all-cause and cardiovascular mortality were examined independently and interactively in overall and subgroups. There was no association between serum phosphorus with all-cause and cardiovascular mortality, but significant interactions (p = 0.02) between phosphorus and albumin existed in overall population. Patients in subgroup with high phosphorus and low albumin were at greater risk of all-cause (HR 1.95, 95%CI 1.27–2.98, p = 0.002) but not cardiovascular mortality (HR 0.37, 95%CI 0.10–1.33, p = 0.13), as compared to those with low phosphorus and high albumin. In contrast, patients with both low parameters had a higher risk of all-cause (HR 1.75, 95%CI 1.22–2.50, p = 0.002) and cardiovascular mortality (HR 1.92, 95%CI 1.07–3.45, p = 0.03). Notably, an elevated risk of both all-cause and cardiovascular mortality was observed in those with low serum albumin, irrespective of phosphorus levels, suggesting low albumin may be useful to identify a higher-risk subgroup of patients undergoing CAPD with different serum phosphorus levels.Naya HuangHuiyan LiLi FanQian ZhouDongying FuLin GuoChunyan YiXueqing YuXueqing YuHaiping MaoFrontiers Media S.A.articleserum phosphorusalbuminperitoneal dialysisinteractionmortalityMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	serum phosphorus albumin peritoneal dialysis interaction mortality Medicine (General) R5-920
spellingShingle	serum phosphorus albumin peritoneal dialysis interaction mortality Medicine (General) R5-920 Naya Huang Huiyan Li Li Fan Qian Zhou Dongying Fu Lin Guo Chunyan Yi Xueqing Yu Xueqing Yu Haiping Mao Serum Phosphorus and Albumin in Patients Undergoing Peritoneal Dialysis: Interaction and Association With Mortality
description	Hyperphosphatemia and hypoalbuminemia confer worse clinical outcomes, whether these risk factors interact to predispose to mortality is unclear. In this prospective cohort study, 2,118 patients undergoing incident continuous ambulatory peritoneal dialysis (CAPD) were enrolled and categorized into four groups based on the changing point regarding mortality at 1.5 mmol/L for serum phosphorus and 35 g/L for serum albumin. Risks of all-cause and cardiovascular mortality were examined independently and interactively in overall and subgroups. There was no association between serum phosphorus with all-cause and cardiovascular mortality, but significant interactions (p = 0.02) between phosphorus and albumin existed in overall population. Patients in subgroup with high phosphorus and low albumin were at greater risk of all-cause (HR 1.95, 95%CI 1.27–2.98, p = 0.002) but not cardiovascular mortality (HR 0.37, 95%CI 0.10–1.33, p = 0.13), as compared to those with low phosphorus and high albumin. In contrast, patients with both low parameters had a higher risk of all-cause (HR 1.75, 95%CI 1.22–2.50, p = 0.002) and cardiovascular mortality (HR 1.92, 95%CI 1.07–3.45, p = 0.03). Notably, an elevated risk of both all-cause and cardiovascular mortality was observed in those with low serum albumin, irrespective of phosphorus levels, suggesting low albumin may be useful to identify a higher-risk subgroup of patients undergoing CAPD with different serum phosphorus levels.
format	article
author	Naya Huang Huiyan Li Li Fan Qian Zhou Dongying Fu Lin Guo Chunyan Yi Xueqing Yu Xueqing Yu Haiping Mao
author_facet	Naya Huang Huiyan Li Li Fan Qian Zhou Dongying Fu Lin Guo Chunyan Yi Xueqing Yu Xueqing Yu Haiping Mao
author_sort	Naya Huang
title	Serum Phosphorus and Albumin in Patients Undergoing Peritoneal Dialysis: Interaction and Association With Mortality
title_short	Serum Phosphorus and Albumin in Patients Undergoing Peritoneal Dialysis: Interaction and Association With Mortality
title_full	Serum Phosphorus and Albumin in Patients Undergoing Peritoneal Dialysis: Interaction and Association With Mortality
title_fullStr	Serum Phosphorus and Albumin in Patients Undergoing Peritoneal Dialysis: Interaction and Association With Mortality
title_full_unstemmed	Serum Phosphorus and Albumin in Patients Undergoing Peritoneal Dialysis: Interaction and Association With Mortality
title_sort	serum phosphorus and albumin in patients undergoing peritoneal dialysis: interaction and association with mortality
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/be8e1d95d1ee407baf0ba10f43a24976
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Serum Phosphorus and Albumin in Patients Undergoing Peritoneal Dialysis: Interaction and Association With Mortality

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