Kidney Week

Abstract: PUB054

Serum Phosphate Levels Predict One-Year Nonenrollment in Patients on Dialysis

Session Information

• Publication Only

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Arimura, Yoshihiro, Kichijoji Asahi Hospital, Musashino, Tokyo, Japan

Yoshihiro Arimura, MD

• Mizuno, Akiko, Seijo Jin Clinic, Setagaya, Tokyo, Japan

Akiko Mizuno

• Kuse, Manabu, Ryokuentoshi Clinic, Yokohama, Kanagawa, Japan

Manabu Kuse

• Yoshimura, Ashio, Yokohama Daiichi Hospital, Yokohama, Kanagawa, Japan

Ashio Yoshimura, MD, PhD

• Hisa, Yuichi, Zenjinkai Group, Kanagawa,Japan, Yokohama, Kanagawa, Japan

Yuichi Hisa

• Ui, Junichi, Zenjinkai Group, Kanagawa,Japan, Yokohama, Kanagawa, Japan

Junichi Ui

• Tagawa, Hitoshi, Kichijoji Asahi Hospital, Musashino, Tokyo, Japan

Hitoshi Tagawa, MD

Background

Dialysis patients may become non-enrolled due to prolonged hospitalization or death. We investigated the association between serum phosphate levels and the 1-year non-enrollment rate and developed a prediction model.

Methods

We analyzed 9,211 maintenance dialysis patients enrolled in December 2022 and followed for 1 year in the Zenjinkai Group. A prediction model was developed using multivariable logistic regression incorporating age, sex, and clinical and nutritional variables. Model performance was assessed by comparing predicted and observed outcomes. The effects of serum phosphate levels, sex, and diabetes were also evaluated.

Results

The 1-year non-enrollment rate was 12.5%, and the predicted rate was 12.2%, showing good agreement. Patients with serum phosphate levels within the target range had a lower rate (6.9%), whereas deviations of ±1.0 mg/dL increased the rate to 10.5%, suggesting a dose-dependent relationship. Serum phosphate levels independently predicted non-enrollment. The risk was higher in males (OR 1.37, 95% CI 1.15–1.64, p=0.0005) and in patients with diabetes.

Conclusion

This model accurately reflects real-world outcomes. Maintaining serum phosphate within the target range may help reduce non-enrollment risk. These findings from a large, recent real-world cohort support the clinical utility of serum phosphate control in dialysis patients.