Abstract:

Ｏｂｊｅｃｔｉｖｅ：Whether higher serum phosphorus is associated with the progression of chronic kidney disease (CKD) is not well elucidated. The aim of this study will analyze the effect of serum phosphorus level on the prognosis of diabetic nephropathy and non diabetic nephropathy.
Ｍｅｔｈｏｄｏｌｏｇｙ：One thousand seven hundred fifty seven patients who diagnosed as diabetic nephropathy with an average eGFR 733±306 ml/min·173m2 (n=591) and nondiabetic nephropathy with an average eGFR 872±316 ml/min·173m2 {n=1 166, IgA nephropathy (n=957), and membranous nephropathy (n=209)} with stage 1～4 CKD were retrospectively investigated. The median follow up time was 65 months. The four cohorts were classified into four groups based on the quartile of serum phosphorus, included as a categorical variable in the multivariate cox regression to evaluate the effects of serum phosphorus level on the prognosis of CKD.
Ｒｅｓｕｌｔｓ：In all patients, univariate and multivariate cox regression indicated that the risk of end point was 529 (P<0001) and 259 (P<0001) times higher in the highest quartile of phosphorus than the lowest quartile. In diabetic nephropathy patients, univariate and multivariate cox regression revealed that the risk of end point was 599 (P<0001) and 238 (P=0024) times higher in the highest quartile of phosphorus. While in non diabetic nephropathy, multivariate cox regression showed no relation between phosphorus level and progression of CKD.
Ｃｏｎｃｌｕｓｉｏｎ：The association of serum phosphorus with progression of kidney disease might vary in specific CKD patient subgroups. Hyperphosphatemia is an independent risk factor for ESRD in diabetic nephropathy. Analysis of serum phosphorus level on the prognosis of patients with CKD should consider the effect of the underlying disease.

Key words: chronic kidney diseasese, rum phosphoruseGFR,  , risk factors