Aims: To describe the characteristics of chronic kidney disease patients with hyperphosphatemia before dialysis. To assess the impact of pre-dialysis hyperphosphatemia on dialysis mortality.
Methods: All patients beginning a dialysis treatment in 2005-2006 in all the nephrology units operating in the Lorraine region of northeastern France were considered. Among them, those who were referred to a nephrologist more than 1 month before dialysis and had atleast one pre-dialysis phosphatemia measurement were included. All-cause mortality during the first year of dialysis was the outcome of interest and phosphatemia level the parameter of interest.
Results: Of 406 patients included (mean age, 68.2 ± 14.8 years), 53% had pre-dialysis hyperphosphatemia, defined by a mean serum phosphate > 1.45 mmol/L during an average pre-dialysis nephrology follow-up period of 10 months. Patients with hyperphosphatemia were younger than those with normophosphatemia, and more often women. They were more likely to have diabetic nephropathy, less likely to have hypertensive nephropathy and cardiovascular comorbidity, and had fewer comorbidities. We found no association between hyperphosphatemia and mortality.
Conclusions: This study shows that patients with pre-dialysis hyperphosphatemia differ from those with normophosphatemia. Larger studies are warranted to confirm or refute the absence of a relationship between predialysis hyperphosphatemia and dialysis mortality.
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