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Kidney Week

Abstract: TH-PO0478

A Study Correlating Serum Phosphorus with Endothelial Cell Dysfunction Markers in CKD 5D

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Prasad, Deepakkumar Dudhnath, P D Hinduja Hospital and Medical Research Center, Mumbai, MH, India
  • Prasad, Khairwar Mahesh, P D Hinduja Hospital and Medical Research Center, Mumbai, MH, India
  • Almeida, Alan F., P D Hinduja Hospital and Medical Research Center, Mumbai, MH, India
  • Sirsat, Rasika, P D Hinduja Hospital and Medical Research Center, Mumbai, MH, India
  • Dey, Ayan Kumar, P D Hinduja Hospital and Medical Research Center, Mumbai, MH, India
Background

Cardiovascular disease is a leading cause of mortality in end-stage kidney disease patients on MHD. Endothelial dysfunction, characterized by impaired nitric oxide production, increased vasoconstrictors and adhesion molecules, is a major contributor. Elevated serum phosphorus levels in CKD patients exacerbate this dysfunction by promoting oxidative stress, vascular calcification, and inflammation. However, there is limited clinical data correlating serum phosphate with endothelial injury in hemodialysis patients.

Methods

Prospective study of 37 hemodialysis patients over 6 months. BP (average of 1 week), S. phosphorus, endothelin-1 and ICAM-1 levels measured before first dialysis of the week at baseline and at follow-up after 6 months. Correlation analyses were performed.

Results

Mean serum phosphate decreased from 5.45 ± 1.64 to 4.79 ± 1.50 mg/dL.
Endothelin-1 decreased from 2.97 ± 1.47 to 2.52 ± 0.90ng/mL.
ICAM-1 decreased from 563.87 ± 157.71 to 547.44 ± 161.76 ng/mL.
Significant positive correlation between phosphate and ICAM-1 at baseline (ρ= 0.359, p=0.0291) and follow-up (ρ= 0.382, p= 0.0196)
Strong correlation between change in phosphate and change in ICAM-1 (ρ= 0.83, p< 0.001)
Moderate correlation between phosphate change and endothelin-1 change (ρ= 0.587, p= 0.001)
No correlation between serum phosphate and BP measurements.

Conclusion

The study highlights significant association between serum phosphate and markers of endothelial dysfunction - Endothelin-1 ICAM-1. The findings emphasize the potential cardiovascular benefits of maintaining optimal phosphate levels in hemodialysis patients. Managing hyperphosphatemia may help reduce endothelial injury and its cardiovascular consequences.

Correlation of serum phosphate with endothelin-1 and ICAM-1 over 6 months

Digital Object Identifier (DOI)