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Serum phosphate optimal timing and range associated with patients survival in haemodialysis: The COSMOS study

dc.contributor.authorFernández-Martín J.L.
dc.contributor.authorDusso A.
dc.contributor.authorMartínez-Camblor P.
dc.contributor.authorDionisi M.P.
dc.contributor.authorFloege J.
dc.contributor.authorKetteler M.
dc.contributor.authorLondon G.
dc.contributor.authorLocatelli F.
dc.contributor.authorGórriz J.L.
dc.contributor.authorRutkowski B.
dc.contributor.authorBos W.-J.
dc.contributor.authorTielemans C.
dc.contributor.authorMartin P.-Y.
dc.contributor.authorWüthrich R.P.
dc.contributor.authorPavlovic D.
dc.contributor.authorBenedik M.
dc.contributor.authorRodríguez-Puyol D.
dc.contributor.authorCarrero J.J.
dc.contributor.authorZoccali C.
dc.contributor.authorCannata-Andía J.B.
dc.contributor.authorCovic A.
dc.contributor.authorFerreira A.
dc.contributor.authorGoldsmith D.
dc.contributor.authorKramar R.
dc.contributor.authorMemmos D.
dc.contributor.authorNagy J.
dc.contributor.authorTeplan V.
dc.contributor.authorVerbeelen D.
dc.contributor.authorMotellón J.L.
dc.contributor.authorTurner M.
dc.contributor.authorChaussy J.
dc.contributor.authorMolemans B.
dc.contributor.authorZani W.
dc.contributor.authorRosser D.
dc.contributor.authorDehmel B.
dc.contributor.authorFouqueray B.
dc.contributor.authorBradbury B.
dc.contributor.authorAcquavella J.
dc.contributor.authorHollowell J.
dc.contributor.authorCarter D.
dc.contributor.authorHolland P.
dc.contributor.authorBaños A.
dc.contributor.authorMattin C.
dc.contributor.authorCritchlow C.
dc.contributor.authorKim J.
dc.contributor.authorLewis C.
dc.contributor.authorPanayi A.
dc.contributor.authorHemetsberger M.
dc.contributor.authorCroft S.
dc.contributor.authorJaeger P.
dc.contributor.authorMuehlebach P.
dc.contributor.authorBlackburn J.
dc.contributor.authorZumsteg E.
dc.contributor.authorRodríguez S.
dc.contributor.authorPérez A.
dc.contributor.authorFaner P.
dc.contributor.authorIzco I.
dc.contributor.authorTraseira S.
dc.contributor.authorCastro C.
dc.contributor.authorMoreno J.
dc.contributor.authorCalle D.
dc.contributor.authorPieraccini F.
dc.date.accessioned2020-09-02T22:17:29Z
dc.date.available2020-09-02T22:17:29Z
dc.date.issued2019
dc.identifier10.1093/ndt/gfy093
dc.identifier.citation34, 4, 673-681
dc.identifier.issn09310509
dc.identifier.urihttps://hdl.handle.net/20.500.12728/4454
dc.descriptionBackground. Serum phosphate is a key parameter in the management of chronic kidney disease-mineral and bone disorder (CKD-MBD). The timing of phosphate measurement is not standardized in the current guidelines. Since the optimal range of these biomarkers may vary depending on the duration of the interdialytic interval, in this analysis of the Current management of secondary hyperparathyroidism: a multicentre observational study (COSMOS), we assessed the influence of a 2- (midweek) or 3-day (post-weekend) dialysis interval for blood withdrawal on serum levels of CKD-MBD biomarkers and their association with mortality risk. Methods. The COSMOS cohort (6797 patients, CKD Stage 5D) was divided into two groups depending upon midweek or post-weekend blood collection. Univariate and multivariate Cox's models adjusted hazard ratios (HRs) by demographics and comorbidities, treatments and biochemical parameters from a patient/centre database collected at baseline and every 6 months for 3 years. Results. There were no differences in serum calcium or parathyroid hormone levels between midweek and post-weekend patients. However, in post-weekend patients, the mean serum phosphate levels were higher compared with midweek patients (5.5 ± 1.4 versus 5.2 ± 1.4 mg/dL, P < 0.001). Also, the range of serum phosphate with the lowest mortality risk [HR ≤ 1.1; midweek: 3.5-4.9 mg/dL (95% confidence interval, CI: 2.9-5.2 mg/dL); post-weekend: 3.8-5.7 mg/dL (95% CI: 3.0-6.4 mg/dL)] showed significant differences in the upper limit (P = 0.021). Conclusion. Midweek and post-weekend serum phosphate levels and their target ranges associated with the lowest mortality risk differ. Thus, clinical guidelines should consider the timing of blood withdrawal when recommending optimal target ranges for serum phosphate and therapeutic strategies for phosphate control. © 2018 The Author(s).
dc.language.isoen
dc.publisherOxford University Press
dc.subjectcalcaemia
dc.subjectchronic haemodialysis
dc.subjectepidemiology
dc.subjecthyperparathyroidism
dc.subjectphosphataemia
dc.subjectalbumin
dc.subjectbiological marker
dc.subjectcalcium
dc.subjecthemoglobin
dc.subjectparathyroid hormone
dc.subjectphosphate
dc.subjectbiological marker
dc.subjectcalcium
dc.subjectparathyroid hormone
dc.subjectphosphate
dc.subjectadult
dc.subjectalbumin blood level
dc.subjectall cause mortality
dc.subjectArticle
dc.subjectblood sampling
dc.subjectbody mass
dc.subjectcalcium blood level
dc.subjectchronic kidney disease-mineral and bone disorder
dc.subjectclinical assessment
dc.subjectcohort analysis
dc.subjectcomorbidity
dc.subjectfemale
dc.subjecthemodialysis
dc.subjecthemoglobin blood level
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmiddle aged
dc.subjectmortality risk
dc.subjectmulticenter study
dc.subjectobservational study
dc.subjectparathyroid hormone blood level
dc.subjectphosphate blood level
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectblood
dc.subjectchronic kidney disease-mineral and bone disorder
dc.subjectclinical trial
dc.subjecthemodialysis
dc.subjectmortality
dc.subjectprognosis
dc.subjectrandomization
dc.subjectsecondary hyperparathyroidism
dc.subjectsurvival rate
dc.subjectBiomarkers
dc.subjectCalcium
dc.subjectChronic Kidney Disease-Mineral and Bone Disorder
dc.subjectFemale
dc.subjectHumans
dc.subjectHyperparathyroidism, Secondary
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectParathyroid Hormone
dc.subjectPhosphates
dc.subjectPrognosis
dc.subjectProspective Studies
dc.subjectRandom Allocation
dc.subjectRenal Dialysis
dc.subjectSurvival Rate
dc.titleSerum phosphate optimal timing and range associated with patients survival in haemodialysis: The COSMOS study
dc.typeArticle


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