Department of Nephrology, Qilu Hospital of Shandong University, No. 107, West Culture Road, Jinan, 250000, Shandong, China.
Department of Neurosurgery, People's Hospital of Zhangdian District, Zibo, Shandong, China.
Int Urol Nephrol. 2024 Jan;56(1):275-282. doi: 10.1007/s11255-023-03678-y. Epub 2023 Jun 19.
The relationship between serum phosphorus and immunoglobulin A (IgA) nephropathy progression remains uncertain, especially normal-range serum phosphorus. Therefore, we herein examined the relationship between the normal-range serum phosphorus and the progression of IgA nephropathy.
One hundred sixty-two patients with primary IgA nephropathy were divided into three groups according to tertiles of baseline serum phosphorus (first tertile: 0.73-1.04 mmol/L; second tertile: 1.04-1.21 mmol/L; third tertile: 1.21-1.60 mmol/L). Estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration. The composite outcome was defined as a decrease of at least 50% in eGFR from baseline or end-stage kidney disease (ESKD). The association of serum phosphorus with IgA nephropathy progression was estimated using Cox proportional hazards models, adjusting for potential confounders.
During a median 16 month follow-up period, 15 patients reached a composite outcome. In the crude Cox proportional hazard model, baseline serum phosphorus as a continuous variable was associated with increased risk for adverse renal outcomes [hazard ratio (HR) = 63.510, 95% confidence interval (CI) = 3.953-1020.284, P = 0.003], and the high tertile of serum phosphorus group had an increased risk of the composite outcome by using the low tertile group as the reference (HR = 11.895, 95% CI = 1.522-92.993, P = 0.018). After adjustment for traditional risk factors, the high tertile of serum phosphorus group was significantly related to IgA nephropathy progression compared with the low tertile group (HR = 9.424, 95% CI = 1.019-87.165, P = 0.048).
Relatively higher serum phosphorus levels within the normal range were significantly associated with the progression of IgA nephropathy.
血清磷与 IgA 肾病进展之间的关系尚不确定，尤其是正常范围内的血清磷。因此，我们在此检查了正常范围内血清磷与 IgA 肾病进展之间的关系。
将 162 名原发性 IgA 肾病患者根据基线血清磷的三分位（第一三分位：0.73-1.04mmol/L；第二三分位：1.04-1.21mmol/L；第三三分位：1.21-1.60mmol/L）分为三组。采用慢性肾脏病流行病学合作组计算估算肾小球滤过率（eGFR）。复合结局定义为 eGFR 从基线至少下降 50%或终末期肾病（ESKD）。使用 Cox 比例风险模型估计血清磷与 IgA 肾病进展的关系，调整潜在混杂因素。
在中位 16 个月的随访期间，15 例患者达到复合结局。在未经校正的 Cox 比例风险模型中，基线血清磷作为连续变量与不良肾脏结局的风险增加相关[风险比（HR）=63.510，95%置信区间（CI）=3.953-1020.284，P=0.003]，并且使用低值三分位组作为参考时，高值三分位组发生复合结局的风险增加（HR=11.895，95%CI=1.522-92.993，P=0.018）。在调整传统危险因素后，与低值三分位组相比，高值三分位组与 IgA 肾病进展显著相关（HR=9.424，95%CI=1.019-87.165，P=0.048）。
正常范围内相对较高的血清磷水平与 IgA 肾病的进展显著相关。
