Highlights
- •Phosphate levels are associated with subclinical atheromatosis in CKD.
- •The effect of phosphate on subclinical atheromatosis is different according to sex.
- •In men, phosphate levels within the normal range associate with subclinical atheromatosis.
Abstract
Background
Cardiovascular disease is the leading cause of mortality in chronic kidney disease
(CKD). Serum phosphate has been associated to cardiovascular disease in the general
population and this effect seems to be different according to sex. In the present
study we analyze the effect of phosphate on subclinical atherosclerosis in the NEFRONA
population and its effect depending on sex.
Design
Carotid ultrasound assessing the presence of plaques was performed by an itinerant
team in 1687 CKD patients not in dialysis without previous cardiovascular events.
Standard blood test and anthropometrical parameters were also recorded.
Results
Multivariate linear regression to model phosphate levels in patients with CKD showed
an interaction of sex with age. Thus, among men, serum phosphate levels declined significantly
with age almost linearly. Serum phosphate levels in women under the age of 40–45 years
overlapped with those in men and then stayed above, showing and overall constant relationship.
Multivariate logistic regression analysis showed that higher phosphate levels associated
with a higher risk of presenting atheromatous plaque. This risk however was different
according to sex. In men, phosphate levels within the normal range associated with
an increased risk of subclinical atheromatosis whereas in women this risk only increased
with serum levels over the normal range.
Conclusions
This study demonstrates that phosphate levels are associated with the presence of
subclinical atheromatosis in a large CKD population. This effect of phosphate on subclinical
atheromatosis was different according to sex, suggesting that a recommended serum
phosphate levels could be different for male than for female CKD patients.
Keywords
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Article info
Publication history
Published online: February 28, 2015
Accepted:
February 20,
2015
Received in revised form:
February 20,
2015
Received:
October 29,
2014
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
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