Abstract: FR-PO917
Epidemiology and Outcomes of Hyperphosphatemia in Non-Dialysis CKD Patients in China
Session Information
- CKD Epidemiology, Risk Factors, Prevention - II
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Nie, Sheng, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
- Zhou, Shiyu, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
- Gong, Mengchun, Digital Health China Technology Co., Ltd., Beijing, China
- Hou, Fan Fan, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
Background
Information on epidemiology and outcomes of hyperphosphatemia (HP) in non-dialysis CKD (ND-CKD) patients is still lacking.
Methods
Hospitalized patients aged ≥18 years with a diagnosis of CKD between 2013 and 2020 in the China Renal Data System (CRDS) were included. The prevalence of HP (defined as a serum phosphate concentration > 1.45 mmol/L when first detected during hospitalization) was analyzed. Secondary endpoints were use of phosphorus-lowering medications, all-cause mortality, cardiovascular mortality and progression of kidney disease. This is the interim report of the study.
Results
A total of 210,806 ND-CKD patients from 19 hospitals were screened, of whom 157,987 (74.94%) had serum phosphate testing during the first hospitalization. The overall prevalence of HP was 14.83% in these patients (CKD G1 8.26%, G2 6.17%, G3a 7.32%, G3b 12.43%, G4 26.74%, G5 65.85%). The utilization rates of phosphorus-lowering medications (including calcium acetate, calcium carbonate, lanthanum carbonate, and sevelamer carbonate) in ND-CKD G3-5 were 9.62% (G3a), 11.29% (G3b), 14.84% (G4), and 23.92% (G5), respectively. Among 64,662 patients with a median follow-up of 3.3 year on death, patients with HP (n=8856) had a 13% increased risk of all-cause mortality (HR 1.13, 95% CI 1.06-1.22) and a 28% increased risk of cardiovascular mortality (HR 1.28, 95% CI 1.04-1.56), compared with those with normal serum phosphate concentration at baseline with confounders adjusted for age, sex, region, CKD stage, co-morbidity. Among the patients with HP the risk of all-cause mortality and cardiovascular mortality were reduced by 12% and 16%, respectively, in patients with phosphorus-lowering medications compared to those without phosphorus-lowering medications. Among 47,581 patients with a median follow-up of 1.8 years on kidney function, patients with HP (n=3622) had a 9% increased risk of kidney disease progression than those with normal serum phosphate concentration at baseline (HR 1.08, 95% CI 1.00-1.17).
Conclusion
HP is common in ND-CKD in China and is an independent risk factor for mortality and kidney disease progression. The use of phosphorus-lowering medications was associated with the decreased risk of all-cause mortality and cardiovascular mortality in patients with CKD G3-5.
Funding
- Commercial Support – Sanofi