透析前及透析患者血清磷酸盐水平与死亡率之间的关联
The Association Between the Levels of Serum Phosphate and Mortality Rates in Pre-Dialysis and Dialysis Patients.
作者信息
Pezeshgi Aiyoub, Alemohammad Yasaman, Tavasol Arian, Hajishah Hamed, Ghasemi Maryam, Sayadizadeh Mahsa, Estabragh Sajad Raeisi, Haddad Mojtaba, Mahdavynia Soheila, Noormohammad Mehdi
机构信息
Department of Internal Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
出版信息
Indian J Nephrol. 2025 Jul-Aug;35(4):485-489. doi: 10.25259/ijn_398_23. Epub 2024 Aug 29.
BACKGROUND
Discovering predictors to reduce morbidity and mortality in chronic kidney disease (CKD) is now a critical global priority. Serum phosphate level is considered to be a potential marker for mortality rate in patients with CKD. Previous studies examined the independent pathogenic role of phosphorus in the development of CKD and dialysis patients but have yielded contradictory findings. This study aims at evaluating the relationship between serum phosphate levels and death rates in pre-dialysis CKD and maintenance of dialysis patients.
MATERIALS AND METHODS
PubMed, Scopus, and Web of Science were searched by using MeSH term keywords. The authors did screening, data extraction, and quality assessment in accordance with the inclusion criteria. STATA 14.2 was used for statistical analyses. The analysis was performed using the random- and fixed-effects model when the heterogeneity was >50% and ≤50%, respectively. For evaluating publication bias, Funnel plots and Egger tests were used.
RESULTS
Eleven original studies between 2005 and 2021 met the eligibility criteria. The overall estimate of unadjusted HR of all-cause mortality each 1 mg/dL increase in the serum phosphate concentration using the random-effects model in pre-dialysis CKD and dialysis patients was 1.33 (95% CI: 0.97, 1.82, I = 99.1%, P = 0.074), and for adjustment, Hazard ratio was 1.27 (95% CI: 1.15, 1.39, I = 75.4%, P < 0.001).
CONCLUSION
The findings showed the association between serum phosphate levels and death rates in pre-dialysis individuals with CKD and dialysis patients.
背景
发现降低慢性肾脏病（CKD）发病率和死亡率的预测因素是当前全球的一项关键优先事项。血清磷水平被认为是CKD患者死亡率的一个潜在标志物。以往的研究探讨了磷在CKD和透析患者发病过程中的独立致病作用，但结果相互矛盾。本研究旨在评估透析前CKD患者和维持性透析患者血清磷水平与死亡率之间的关系。
材料与方法
使用医学主题词（MeSH）关键词在PubMed、Scopus和Web of Science数据库中进行检索。作者根据纳入标准进行筛选、数据提取和质量评估。使用STATA 14.2进行统计分析。当异质性分别>50%和≤50%时，采用随机效应模型和固定效应模型进行分析。为评估发表偏倚，使用了漏斗图和Egger检验。
结果
2005年至2021年间的11项原始研究符合纳入标准。使用随机效应模型，透析前CKD患者和透析患者血清磷浓度每升高1mg/dL，全因死亡率未调整的HR总体估计值为1.33（95%CI：0.97，1.82，I² = 99.1%，P = 0.074），调整后危险比为1.27（95%CI：1.15，1.39，I² = 75.4%，P < 0.001）。
结论
研究结果表明，透析前CKD患者和透析患者的血清磷水平与死亡率之间存在关联。
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