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Relationships between serum and urine phosphorus with all-cause and cardiovascular mortality: the Osteoporotic Fractures in Men (MrOS) Study.


ABSTRACT: Serum phosphorus is associated with cardiovascular disease (CVD) in the general population, but may not comprehensively reflect phosphorus homeostasis. Whether urine phosphorus-creatinine ratio (a marker of intestinal absorption) or urine fractional excretion of phosphorus (FEPi; a marker of urinary phosphorus handling) is associated with risk of mortality or CVD is uncertain.Prospective observational study.1,325 community-dwelling men 65 years or older participating in the MrOS Study.Serum phosphorus, urine phosphorus-creatinine ratio, and FEPi.All-cause and CVD death.Mean age was 74 ± 6 (SD) years, estimated glomerular filtration rate was 75 ± 16 mL/min/1.73 m(2), and serum phosphorus level was 3.2 ± 0.4 mg/dL. During a median follow-up of 9.3 years, there were 364 (120 CVD) deaths. After adjustment for demographics, CVD risk factors, and kidney function, the risks of all-cause death in the highest quartiles of serum phosphorus (?3.6 mg/dL), urine phosphorus-creatinine ratio (?0.55), and FEPi (?18%) were 1.63 (95% CI, 1.23-2.17), 1.22 (95% CI, 0.90-1.65), and 0.88 (95% CI, 0.64-1.23), respectively, compared to the lowest quartiles of each. Results were similar for CVD death. Results also were similar in those with estimated glomerular filtration rate ?60 and <60 mL/min/1.73 m(2).Older all-male cohort. Few had advanced chronic kidney disease. Spot urine specimens were used.In community-living older men, higher serum phosphorus concentrations are associated with all-cause and CVD death. In contrast, urine phosphorus-creatinine ratio and FEPi are not. These findings do not support using urine phosphorus-creatinine ratio or FEPi as adjuvant measures to predict risk of mortality or CVD in the general population.

SUBMITTER: Dominguez JR 

PROVIDER: S-EPMC3815620 | biostudies-literature | 2013 Apr

REPOSITORIES: biostudies-literature

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Relationships between serum and urine phosphorus with all-cause and cardiovascular mortality: the Osteoporotic Fractures in Men (MrOS) Study.

Dominguez Julie R JR   Kestenbaum Bryan B   Chonchol Michel M   Block Geoffrey G   Laughlin Gail A GA   Lewis Cora E CE   Katz Ronit R   Barrett-Connor Elizabeth E   Cummings Steve S   Orwoll Eric S ES   Ix Joachim H JH  

American journal of kidney diseases : the official journal of the National Kidney Foundation 20121220 4


<h4>Background</h4>Serum phosphorus is associated with cardiovascular disease (CVD) in the general population, but may not comprehensively reflect phosphorus homeostasis. Whether urine phosphorus-creatinine ratio (a marker of intestinal absorption) or urine fractional excretion of phosphorus (FEPi; a marker of urinary phosphorus handling) is associated with risk of mortality or CVD is uncertain.<h4>Study design</h4>Prospective observational study.<h4>Setting & participants</h4>1,325 community-dw  ...[more]

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