Cheungpasitporn Wisit, Thongprayoon Charat, Hansrivijit Panupong, Medaura Juan, Chewcharat Api, Bathini Tarun, Mao Michael A, Erickson Stephen B
Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Adv Biomed Res. 2020 Apr 22;9:14. doi: 10.4103/abr.abr_249_19. eCollection 2020.
Calcium-phosphate product is associated with mortality among patients with end-stage kidney disease on dialysis. However, clinical evidence among hospitalized patients is limited. The objective of this study was to investigate the relationship between admission calcium-phosphate product and 1-year mortality in hospitalized patients.
All adult patients admitted to a tertiary referral hospital in 2009-2013 were studied. Patients who had both available serum calcium and phosphate measurement within 24 h of hospital admission were included. Admission calcium-phosphate product (calcium × phosphate) was stratified based on its distribution into six groups: <21, 21-<27, 27-<33, 33-<39, 39-<45, and ≥45 mg/dL. Multivariate cox proportional hazard analysis was performed to evaluate the association between admission calcium-phosphate product and 1-year mortality, using the calcium-phosphate product of 33-<39 mg/dL as the reference group.
A total of 14,772 patients were included in this study. The mean admission calcium-phosphate product was 34.4 ± 11.3 mg/dL. Of these patients, 3194 (22%) died within 1 year of hospital admission. In adjusted analysis, admission calcium-phosphate product of ≥45 mg/dL was significantly associated with increased 1-year mortality with hazard ratio of 1.41 (95% 95% confidence interval 1.25-1.67), whereas lower admission calcium-phosphate product was not significantly associated with 1-year mortality.
Elevated calcium-phosphate product was significantly associated with increased 1-year mortality in hospitalized patients.
钙磷乘积与接受透析的终末期肾病患者的死亡率相关。然而，住院患者中的临床证据有限。本研究的目的是调查住院患者入院时的钙磷乘积与1年死亡率之间的关系。
对2009年至2013年入住一家三级转诊医院的所有成年患者进行研究。纳入入院后24小时内同时有血清钙和磷测量值的患者。入院时的钙磷乘积（钙×磷）根据其分布分为六组：<21、21-<27、27-<33、33-<39、39-<45和≥45mg/dL。以33-<39mg/dL的钙磷乘积作为参照组，进行多变量Cox比例风险分析，以评估入院时钙磷乘积与1年死亡率之间的关联。
本研究共纳入14772例患者。入院时钙磷乘积的平均值为34.4±11.3mg/dL。在这些患者中，3194例（22%）在入院后1年内死亡。在调整分析中，入院时钙磷乘积≥45mg/dL与1年死亡率增加显著相关，风险比为1.41（95%置信区间1.25-1.67），而较低的入院时钙磷乘积与1年死亡率无显著关联。
住院患者中，升高的钙磷乘积与1年死亡率增加显著相关。
