Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study

Abstract The use of phosphate (P)-binders allows hemodialysis patients to take in more protein and thus may maintain a good nutritional status. Protein-energy-malnutrition increases the risk of infection-related death. The association between use of P-binders and the relative risks of infection-rela...

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Autores principales:	Shunsuke Yamada, Masanori Tokumoto, Masatomo Taniguchi, Hisako Yoshida, Hokuto Arase, Narihito Tatsumoto, Hideki Hirakata, Takanari Kitazono, Kazuhiko Tsuruya
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d28e5f207a7b4dafa65296d34a2dd25a
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spelling	oai:doaj.org-article:d28e5f207a7b4dafa65296d34a2dd25a2021-12-02T15:08:25ZUse of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study10.1038/s41598-018-29757-02045-2322https://doaj.org/article/d28e5f207a7b4dafa65296d34a2dd25a2018-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-29757-0https://doaj.org/toc/2045-2322Abstract The use of phosphate (P)-binders allows hemodialysis patients to take in more protein and thus may maintain a good nutritional status. Protein-energy-malnutrition increases the risk of infection-related death. The association between use of P-binders and the relative risks of infection-related death remains unknown in hemodialysis patients. A total of 2926 hemodialysis patients registered to the Q-Cohort Study was followed up for 4-years. The association between use of P-binders and the risks for infection-related and all-cause mortality were estimated by Cox proportional hazards risk model with multiple adjustments by conventional and propensity-score based approaches. During the follow-up period, 106 patients and 492 patients died of infection and any cause, respectively. Cox proportional hazards models with multivariable adjustments including nutritional confounders showed that the incidence of infection-related death was significantly lower in patients with P-binders use compared with those without (hazard ratio [95% confidence interval] for infection-related mortality 0.63 [0.40–0.99]). The results remained significant even after applying four different propensity score-based analyses. Notably, use of P-binders was associated with a lower risk of all-cause mortality. Further studies including randomized controlled clinical trials and observational studies analyzed by an instrumental variable model will provide more robust evidences for the associations observed in our study.Shunsuke YamadaMasanori TokumotoMasatomo TaniguchiHisako YoshidaHokuto AraseNarihito TatsumotoHideki HirakataTakanari KitazonoKazuhiko TsuruyaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-11 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shunsuke Yamada Masanori Tokumoto Masatomo Taniguchi Hisako Yoshida Hokuto Arase Narihito Tatsumoto Hideki Hirakata Takanari Kitazono Kazuhiko Tsuruya Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study
description	Abstract The use of phosphate (P)-binders allows hemodialysis patients to take in more protein and thus may maintain a good nutritional status. Protein-energy-malnutrition increases the risk of infection-related death. The association between use of P-binders and the relative risks of infection-related death remains unknown in hemodialysis patients. A total of 2926 hemodialysis patients registered to the Q-Cohort Study was followed up for 4-years. The association between use of P-binders and the risks for infection-related and all-cause mortality were estimated by Cox proportional hazards risk model with multiple adjustments by conventional and propensity-score based approaches. During the follow-up period, 106 patients and 492 patients died of infection and any cause, respectively. Cox proportional hazards models with multivariable adjustments including nutritional confounders showed that the incidence of infection-related death was significantly lower in patients with P-binders use compared with those without (hazard ratio [95% confidence interval] for infection-related mortality 0.63 [0.40–0.99]). The results remained significant even after applying four different propensity score-based analyses. Notably, use of P-binders was associated with a lower risk of all-cause mortality. Further studies including randomized controlled clinical trials and observational studies analyzed by an instrumental variable model will provide more robust evidences for the associations observed in our study.
format	article
author	Shunsuke Yamada Masanori Tokumoto Masatomo Taniguchi Hisako Yoshida Hokuto Arase Narihito Tatsumoto Hideki Hirakata Takanari Kitazono Kazuhiko Tsuruya
author_facet	Shunsuke Yamada Masanori Tokumoto Masatomo Taniguchi Hisako Yoshida Hokuto Arase Narihito Tatsumoto Hideki Hirakata Takanari Kitazono Kazuhiko Tsuruya
author_sort	Shunsuke Yamada
title	Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study
title_short	Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study
title_full	Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study
title_fullStr	Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study
title_full_unstemmed	Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study
title_sort	use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: the q-cohort study
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/d28e5f207a7b4dafa65296d34a2dd25a
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Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study

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