ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO160

An FGF-23-Independent Association Between Serum Phosphorus and Left Ventricular Hypertrophy: Findings from the KNOW-CKD Study

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Hyun, Young Youl, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Han, Jimin, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Kim, Hyang, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lee, Kyu-Beck, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)

Group or Team Name

  • KNOW-CKD Study Investigators
Background

Previous studies have shown that serum phosphorus is related to left ventricular hypertrophy (LVH) in chronic kidney disease (CKD). However, those studies were small in size or did not show significant association when fibroblast growth factor-23 (FGF23) was included in the analysis. The aim of this study was to verify the FGF23-independent association between serum phosphorus and LVH in a CKD cohort of Korean adults.

Methods

This cross-sectional study analyzed 1,545 predialysis CKD patients from the KNOW-CKD cohort. Left ventricular mass index (LVMI) and presence of LVH were assessed by echocardiography. Multivariate regression analysis was adjusted for various cardiovascular risk factors including FGF23.

Results

The LVMI was higher among the higher serum phosphorus groups (88.6±20.7, 90.3±22.5, 91.1±22.0, and 96.2±25.4 for the 1st to 4th phosphorus quartiles, respectively, P<0.001). LVH was more prevalent among the higher serum phosphorus groups (15.2%, 15.8%, 23.7%, and 35.9% for the 1st to 4th phosphorus quartiles, respectively, P<0.001). For each 1 mg/dL increase in serum phosphorus, LVMI increased by 3.88 g/m2. The adjusted odds ratio for LVH in the 4th quartile of serum phosphorus compared to the 1st quartile was 1.79 (95% CI, 1.19-2.70; P=0.005). Results were summarized in the Table 1.

Conclusion

High serum phosphorus was associated with high LVMI and LVH in predialysis CKD patients. This relationship was independent of various cardiovascular risk factors, including FGF23.

Table 1. The association between serum phosphorus quartile and left ventricular hypertrophy
Serum phosphorus quartilesModel 1Model 2Model 3
OR (95% CI)P valueOR (95% CI)P valueOR (95% CI)P value
1reference reference reference 
21.04 (0.72-1.52)0.8230.91 (0.61-1.36)0.6500.97 (0.65-1.45)0.893
31.73 (1.21-2.48)0.0031.17 (0.78-1.74)0.4451.27 (0.85-1.89)0.251
43.12 (2.21-4.39)<0.0011.68 (1.12-2.52)0.0111.79 (1.19-2.70)0.005

Model 1: unadjusted; Model 2: adjusted for age, sex, BMI, systolic blood pressure, diabetes, eGFR, LDL cholesterol, hsCRP, random urine PCR, hemoglobin, current smoking, taking renin-angiotensin system blockers, serum calcium, 25-OH-vit D and iPTH; Model 3: adjusted for model 3 + FGF23

Funding

  • Government Support - Non-U.S.