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High Phosphorus Level Tied to Kidney Disease Mortality

Insufficient evidence to link calcium, parathyroid hormone levels with death or cardiac events

TUESDAY, March 15 (HealthDay News) -- In patients with chronic kidney disease, evidence suggests that there is an association between higher serum levels of phosphorus and mortality, but there is a lack of strong and consistent evidence associating serum calcium and parathyroid hormone levels with risk of death or cardiovascular events, according to a meta-analysis published in the March 16 issue of the Journal of the American Medical Association.

Suetonia C. Palmer, M.B.Ch.B., Ph.D., from the University of Otago in Christchurch, New Zealand, and colleagues analyzed data from 47 cohort studies, including 327,644 patients, to evaluate the association between levels of serum phosphorus, parathyroid hormone, and calcium with risks of death, cardiovascular mortality, and nonfatal cardiovascular events in chronic kidney disease. Data for the associations of the levels of phosphorus, parathyroid hormone, and calcium with cardiovascular death were each available from only one cohort study with adequate adjustment for confounders.

The investigators found an 18 percent increase in the relative risk (RR) of death for every 1-mg/dL increase in serum phosphorus (RR, 1.18). All-cause mortality was not significantly associated with a similar increase in serum level of parathyroid hormone (RR, 1.01) or calcium (RR, 1.08).

"The evidence for an association between serum levels of phosphorus, calcium, or parathyroid hormone as risk factors for outcomes in individuals with chronic kidney disease (at any stage) is currently insufficient to inform clinical decision making, policy, or practice guidelines," the authors write.

Two authors disclosed financial relationships with the pharmaceutical industry.

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