Serum phosphate and outcome at one year after deceased donor renal transplantation

Stevens, K.K., Morgan, I.R., Patel, R.K., Geddes, C.C., Mark, P.B. , Jardine, A.G. and Delles, C. (2011) Serum phosphate and outcome at one year after deceased donor renal transplantation. Clinical Transplantation, 25(2), E199-E204. (doi: 10.1111/j.1399-0012.2011.01400.x)

Abstract

Traditional risk factors do not adequately explain the increased prevalence of cardiovascular disease in renal patients. This study considered a "non-traditional" risk factor, serum phosphate and outcome in renal transplant recipients. Data from 377 patients who received a first deceased donor renal transplant between January 1, 1999, and December 31, 2008, were recorded; 10% (n=38) had diabetes, 16.7% (n=63) were smokers, and 18.8% (n=71) had a history of vascular disease. Three hundred and thirty-three patients were alive at the time of the analysis. Survivors were significantly younger, less likely to be smokers or diabetic, and had a higher estimated glomerular filtration rate at one yr post-transplantation. Serum phosphate was significantly lower in these patients (0.95 +/- 0.23 vs. 1.04 +/- 0.26, p=0.031). Analysis of recipient survival, stratified by serum phosphate at one yr post-transplant, revealed that serum phosphate > 1.11 mMol/L was a significant predictor of all-cause mortality (p=0.006). Serum phosphate between 0.9 and 1.11 mMol/L afforded the best outcome. In multivariate analysis, serum phosphate remained a significant predictor of mortality (p=0.016). Serum phosphate at one yr after transplant seems to have a J-shaped relationship with mortality, and this effect is independent of traditional cardiovascular risk factors.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Patel, Dr Rajan and Stevens, Dr Kathryn and Mark, Professor Patrick and Delles, Professor Christian and Geddes, Dr Colin and Jardine, Professor Alan
• Authors: Stevens, K.K., Morgan, I.R., Patel, R.K., Geddes, C.C., Mark, P.B., Jardine, A.G., and Delles, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Clinical Transplantation
• Publisher: John Wiley & Sons A/S
• ISSN: 0902-0063
• ISSN (Online): 1399-0012
• Published Online: 09 February 2011