Abstract: FR-PO0268
Association Between Serum Glycerol-3-Phosphate and Mortality in Patients on Hemodialysis
Session Information
- Bone and Mineral Metabolism: Clinical Epidemiology and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Nakagawa, Yosuke, Tokai Daigaku Igakubu Jin Naibunpi Taisha Naika, Isehara, Kanagawa Prefecture, Japan
- Ito, Masatoshi, St. Marianna University School of Medicine Department of Legal Medicine, Kawasaki, Japan
- Ishioka, Chigusa, Tokai Daigaku Igakubu Jin Naibunpi Taisha Naika, Isehara, Kanagawa Prefecture, Japan
- Kakuta, Takatoshi, Tokai Daigaku Igakubu Jin Naibunpi Taisha Naika, Isehara, Kanagawa Prefecture, Japan
- Komaba, Hirotaka, Tokai Daigaku Igakubu Jin Naibunpi Taisha Naika, Isehara, Kanagawa Prefecture, Japan
Background
Recent studies have shown that glycerol-3-phosphate (G-3-P), a byproduct of glycolysis, is secreted from the proximal tubules in response to dietary phosphate load and stimulates osteocytes to promote fibroblast growth factor 23 (FGF23) production. However, the role of G-3-P in patients with kidney failure remains unclear.
Methods
We analyzed a prospective cohort study of 650 patients undergoing maintenance hemodialysis. The primary exposure was the baseline serum G-3-P levels measured at study enrollment. The primary outcome was 8-year all-cause mortality. Mortality risk was assessed using Cox regression models adjusted for potential confounders. Serum G-3-P was measured using liquid chromatography-mass spectrometry.
Results
The median serum G-3-P concentration was 220 ng/mL, which was markedly higher than in healthy individuals (98 ng/mL). Patients with higher G-3-P levels were more likely to be male, younger, and diabetic; they also had better nutritional status and higher levels of phosphate and FGF23. Additionally, patients with higher G-3-P levels had lower prevalence of stroke and peripheral artery disease. During a median follow-up of 8.0 years (interquartile range, 4.1–10.2 years), 229 of 650 patients died. In a univariate analysis, higher G-3-P levels were significantly associated with a lower risk of all-cause mortality (hazard ratio per doubling, 0.82; 95% confidence interval, 0.75-0.89). This association remained significant after adjustment for age, sex, dialysis vintage, diabetes, history of cardiovascular disease, and nutritional markers. Similar results were obtained for cardiovascular mortality.
Conclusion
Higher serum G-3-P levels were independently associated with lower all-cause mortality in maintenance hemodialysis patients. Further research is required to determine the potential role of G-3-P in patients with kidney failure.