10.5061/DRYAD.6V0J9
Jung, Su-Young J
Yonsei University
Kwon, Jaeyeol
Yonsei University
Park, Seohyun
Yonsei University
Jhee, Jong Hyun
Yonsei University
Yun, Hae-Ryong
Yonsei University
Kim, HyoungNae
Yonsei University
Kee, Youn Kyung
Yonsei University
Yoon, Chang-Yun
Yonsei University
Chang, Tae-Ik
Kang, Ea Wha
Park, Jung Tak
Yonsei University
Yoo, Tae-Hyun
Yonsei University
Kang, Shin-Wook
Yonsei University
Han, Seung Hyeok
Yonsei University
Data from: Phosphate is a potential biomarker of disease severity and
predicts adverse outcomes in acute kidney injury patients undergoing
continuous renal replacement therapy
Dryad
dataset
2019
Phosphates
Urine
Intensive care units
Body mass index
Kidneys
Chronic kidney disease
Blood pressure
2019-01-09T00:00:00Z
2019-01-09T00:00:00Z
en
https://doi.org/10.1371/journal.pone.0191290
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CC0 1.0 Universal (CC0 1.0) Public Domain Dedication
Hyperphosphatemia is associated with mortality in patients with chronic
kidney disease, and is common in critically ill patients with acute kidney
injury (AKI); however, its clinical implication in these patients is
unknown. We conducted an observational study in 1144 patients (mean age,
63.2 years; male, 705 [61.6%]) with AKI who received continuous renal
replacement therapy (CRRT) between January 2009 and September 2016.
Phosphate levels were measured before (0 h) and 24 h after CRRT
initiation. We assessed disease severity using various clinical
parameters. Phosphate at 0 h positively correlated with the Acute
Physiology and Chronic Health Evaluation II (APACHE II; P < 0.001)
and Sequential Organ Failure Assessment (SOFA; P < 0.001) scores,
and inversely with mean arterial pressure (MAP; P = 0.02) and urine output
(UO; P = 0.01). In a fully adjusted linear regression analysis for age,
sex, Charlson comorbidity index (CCI), MAP, and estimated glomerular
filtration rate (eGFR), higher 0 h phosphate level was significantly
associated with high APACHE II (P < 0.001) and SOFA (P = 0.04)
scores, suggesting that phosphate represents disease severity. A
multivariable Cox model also showed that hyperphosphatemia was
significantly associated with increased 28-day (HR 1.05, 95% CI 1.02-1.08,
P = 0.001) and 90-day (HR 1.05, 95% CI 1.02-1.08, P = 0.001) mortality.
Furthermore, patients with increased phosphate level during 24 h were at
higher risk of death than those with stable or decreased phosphate levels.
Finally, c-statistics significantly increased when phosphate was added to
a model that included age, sex, CCI, body mass index, eGFR, MAP,
hemoglobin, serum albumin, C-reactive protein, and APACHE II score. This
study shows that phosphate is a potential biomarker that can reflect
disease severity and predict mortality in critically ill patients
receiving CRRT.
CRRTstudy_1144patients1144 patients with acute kidney injury who received
continuous renal replacement therapy (CRRT) were enrolled. Phosphate
levels were measured before (0 h) and 24 h after CRRT initiation. We
assessed disease severity using various clinical parameters.