Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2023 |
| Outros Autores: | , , , , , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10362/160040 |
Resumo: | COSMOS is sponsored by the Bone and Mineral Research Unit (Hospital Universitario Central de Asturias), SAFIM (Sociedad Asturiana Fomento Investigaciones Óseas), the European Renal Association. This study has been funded by Instituto de Salud Carlos III (ISCIII), the ISCIII Retic REDinREN (RD06/0016/1013, RD12/0021/0023 and RD16/0009/0017), the ISCIII Red de Investigación Cooperativa Orientada a Resultados en Salud RICORS2040 (RD21/0005/0001 and RD21/0005/0019, Next Generation EU; Recovery, Transformation and Resilience Plan), the ISCIII (ICI14/00107, PI17/00384 and PI20/00633, co-funded by the European Union), Plan Estatal de I + D + I 2013-2016, Plan de Ciencia, Tecnología e Innovación 2013-2017 y 2018-2022 del Principado de Asturias (GRUPIN14-028, IDI-2018-000152, IDI/2021/000080), Fundación Renal Íñigo Álvarez de Toledo (FRIAT) and the Spanish Society of Nephrology (Estudio Estratégico de la SEN). Logistics (meetings, secretarial help, printing of materials, development of website for data entry, etc.) have been financially supported by an unrestricted grant from AMGEN Europe and Fundación Renal Íñigo Álvarez de Toledo (FRIAT). |
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Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patientsCKDbone fragility fractureschronic kidney disease - mineral and bone disorders (CKD-MBD)hemodialysisserum phosphateCOSMOS is sponsored by the Bone and Mineral Research Unit (Hospital Universitario Central de Asturias), SAFIM (Sociedad Asturiana Fomento Investigaciones Óseas), the European Renal Association. This study has been funded by Instituto de Salud Carlos III (ISCIII), the ISCIII Retic REDinREN (RD06/0016/1013, RD12/0021/0023 and RD16/0009/0017), the ISCIII Red de Investigación Cooperativa Orientada a Resultados en Salud RICORS2040 (RD21/0005/0001 and RD21/0005/0019, Next Generation EU; Recovery, Transformation and Resilience Plan), the ISCIII (ICI14/00107, PI17/00384 and PI20/00633, co-funded by the European Union), Plan Estatal de I + D + I 2013-2016, Plan de Ciencia, Tecnología e Innovación 2013-2017 y 2018-2022 del Principado de Asturias (GRUPIN14-028, IDI-2018-000152, IDI/2021/000080), Fundación Renal Íñigo Álvarez de Toledo (FRIAT) and the Spanish Society of Nephrology (Estudio Estratégico de la SEN). Logistics (meetings, secretarial help, printing of materials, development of website for data entry, etc.) have been financially supported by an unrestricted grant from AMGEN Europe and Fundación Renal Íñigo Álvarez de Toledo (FRIAT).BACKGROUND: Bone fragility fractures are associated with high morbidity and mortality. This study analysed the association between the current biochemical parameters of CKD-MBD and bone fragility fractures in the COSMOS project. METHODS: COSMOS is a 3-year, multicentre, open cohort, prospective, observational study carried out in 6797 hemodialysis patients (227 centres from 20 European countries). The association of bone fragility fractures (outcome) with serum calcium, phosphate and PTH (exposure), was assessed using Standard Cox proportional hazards regression and Cox proportional hazards regression for recurrent events. Additional analyses were performed considering all-cause mortality as a competitive event for bone fragility fracture occurrence. Multivariable models were used in all strategies, with the fully adjusted model including a total of 24 variables. RESULTS: During a median follow-up of 24 months 252 (4%) patients experienced at least one bone fragility fracture (incident bone fragility fracture rate 28.5 per 1000 patient-years). In the fractured and non-fractured patients, the percentage of men was 43.7% and 61.4%, mean age 68.1 and 63.8 years and a haemodialysis vintage of 55.9 and 38.3 months respectively. Baseline serum phosphate > 6.1 mg/dL (reference value 4.3-6.1 mg/dL) was significantly associated with a higher bone fragility fracture risk in both regression models (HR: 1.53[95%CI: 1.10-2.13] and HR: 1.44[95%CI: 1.02-2.05]. The significant association persisted after competitive risk analysis (subHR: 1.42[95%CI: 1.02-1.98]) but the finding was not confirmed when serum phosphate was considered as a continuous variable. Baseline serum calcium showed no association with bone fragility fracture risk in any regression model. Baseline serum PTH > 800 pg/mL was significantly associated with a higher bone fragility fracture risk in both regression models, but the association disappeared after a competitive risk analysis. CONCLUSIONS: Hyperphosphatemia was independently and consistently associated with an increased bone fracture risk, suggesting serum phosphate could be a novel risk factor for bone fractures in hemodialysis patients.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNBarrera-Baena, PedroRodríguez-García, MinervaRodríguez-Rubio, EnriqueGonzález-Llorente, LucíaOrtiz, AlbertoZoccali, CarmineLocatelli, FrancescoFloege, JürgenCohen-Solal, MartineFerreira, Manuel AníbalKetteler, MarkusLondon, Gerard MichelGorriz-Teruel, José LuisSánchez-Álvarez, EmilioHevia-Suárez, Miguel ÁngelFernández-Gómez, Jesús MaríaMartín-Carro, BeatrizGómez-Alonso, CarlosAlonso-Montes, CristinaCannata-Andia, Jorge BenitoFernández-Martín, José Luis2023-11-16T22:09:21Z2023-09-022023-09-02T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/160040eng0931-0509PURE: 74233814https://doi.org/10.1093/ndt/gfad190info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:42:33Zoai:run.unl.pt:10362/160040Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:57:49.666124Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients |
| title |
Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients |
| spellingShingle |
Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients Barrera-Baena, Pedro CKD bone fragility fractures chronic kidney disease - mineral and bone disorders (CKD-MBD) hemodialysis serum phosphate |
| title_short |
Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients |
| title_full |
Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients |
| title_fullStr |
Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients |
| title_full_unstemmed |
Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients |
| title_sort |
Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients |
| author |
Barrera-Baena, Pedro |
| author_facet |
Barrera-Baena, Pedro Rodríguez-García, Minerva Rodríguez-Rubio, Enrique González-Llorente, Lucía Ortiz, Alberto Zoccali, Carmine Locatelli, Francesco Floege, Jürgen Cohen-Solal, Martine Ferreira, Manuel Aníbal Ketteler, Markus London, Gerard Michel Gorriz-Teruel, José Luis Sánchez-Álvarez, Emilio Hevia-Suárez, Miguel Ángel Fernández-Gómez, Jesús María Martín-Carro, Beatriz Gómez-Alonso, Carlos Alonso-Montes, Cristina Cannata-Andia, Jorge Benito Fernández-Martín, José Luis |
| author_role |
author |
| author2 |
Rodríguez-García, Minerva Rodríguez-Rubio, Enrique González-Llorente, Lucía Ortiz, Alberto Zoccali, Carmine Locatelli, Francesco Floege, Jürgen Cohen-Solal, Martine Ferreira, Manuel Aníbal Ketteler, Markus London, Gerard Michel Gorriz-Teruel, José Luis Sánchez-Álvarez, Emilio Hevia-Suárez, Miguel Ángel Fernández-Gómez, Jesús María Martín-Carro, Beatriz Gómez-Alonso, Carlos Alonso-Montes, Cristina Cannata-Andia, Jorge Benito Fernández-Martín, José Luis |
| author2_role |
author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
| dc.contributor.author.fl_str_mv |
Barrera-Baena, Pedro Rodríguez-García, Minerva Rodríguez-Rubio, Enrique González-Llorente, Lucía Ortiz, Alberto Zoccali, Carmine Locatelli, Francesco Floege, Jürgen Cohen-Solal, Martine Ferreira, Manuel Aníbal Ketteler, Markus London, Gerard Michel Gorriz-Teruel, José Luis Sánchez-Álvarez, Emilio Hevia-Suárez, Miguel Ángel Fernández-Gómez, Jesús María Martín-Carro, Beatriz Gómez-Alonso, Carlos Alonso-Montes, Cristina Cannata-Andia, Jorge Benito Fernández-Martín, José Luis |
| dc.subject.por.fl_str_mv |
CKD bone fragility fractures chronic kidney disease - mineral and bone disorders (CKD-MBD) hemodialysis serum phosphate |
| topic |
CKD bone fragility fractures chronic kidney disease - mineral and bone disorders (CKD-MBD) hemodialysis serum phosphate |
| description |
COSMOS is sponsored by the Bone and Mineral Research Unit (Hospital Universitario Central de Asturias), SAFIM (Sociedad Asturiana Fomento Investigaciones Óseas), the European Renal Association. This study has been funded by Instituto de Salud Carlos III (ISCIII), the ISCIII Retic REDinREN (RD06/0016/1013, RD12/0021/0023 and RD16/0009/0017), the ISCIII Red de Investigación Cooperativa Orientada a Resultados en Salud RICORS2040 (RD21/0005/0001 and RD21/0005/0019, Next Generation EU; Recovery, Transformation and Resilience Plan), the ISCIII (ICI14/00107, PI17/00384 and PI20/00633, co-funded by the European Union), Plan Estatal de I + D + I 2013-2016, Plan de Ciencia, Tecnología e Innovación 2013-2017 y 2018-2022 del Principado de Asturias (GRUPIN14-028, IDI-2018-000152, IDI/2021/000080), Fundación Renal Íñigo Álvarez de Toledo (FRIAT) and the Spanish Society of Nephrology (Estudio Estratégico de la SEN). Logistics (meetings, secretarial help, printing of materials, development of website for data entry, etc.) have been financially supported by an unrestricted grant from AMGEN Europe and Fundación Renal Íñigo Álvarez de Toledo (FRIAT). |
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2023 |
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2023-11-16T22:09:21Z 2023-09-02 2023-09-02T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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0931-0509 PURE: 74233814 https://doi.org/10.1093/ndt/gfad190 |
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