Serum phosphate measured at 6 and 12 months after successful kidney transplant is independently associated with subsequent graft loss

David Benavente, Colin D Chue, Jason Moore, Clara Addison, Richard Borrows, Charles J Ferro

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

OBJECTIVES: Serum phosphate concentrations have been shown to predict graft loss in prevalent, but not incident, kidney transplant populations. The reasons for this are unknown. We investigated whether serum phosphate at 6 or 12 months posttransplant was associated with graft loss in the same cohort.

MATERIALS AND METHODS: Data were collected for 325 patients transplanted and followed up at a single center (1996-2004). The association between serum phosphate at 6 and 12 months posttransplant and graft failure was analyzed.

RESULTS: Univariable associations with death-censored graft failure were seen for serum phosphate at 6 and 12 months (hazard ratio [HR] 1.33; 95% confidence interval [CI] 1.20-1.48; P < .001, and HR 1.40; CI 1.27-1.54; P < .001). On bivariable analysis (phosphate at 6 vs 12 mo), a significant association remained for both variables and increased graft failure rate (HR 1.19; CI 1.07-1.34; P = .002, and HR 1.37; CI 1.21-1.55; P < .001). These associations persisted in multivariable models (HR 1.27; CI 1.07-1.51; P = .007, and HR 1.34; CI 1.14-1.57; P < .001 for phosphate at 6 and 12 mo).

CONCLUSIONS: Serum phosphate at 6 and 12 months posttransplant is an independent predictor of graft loss. Any future trial designed to investigate the benefits of phosphate lowering should consider recruiting patients as early as 6 months posttransplant.

Original languageEnglish
Pages (from-to)119-24
Number of pages6
JournalExperimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
Volume10
Issue number2
DOIs
Publication statusPublished - Apr 2012

Keywords

  • Adult
  • Biomarkers/blood
  • Cohort Studies
  • Female
  • Graft Survival/physiology
  • Humans
  • Hyperphosphatemia/blood
  • Hypophosphatemia/blood
  • Incidence
  • Kaplan-Meier Estimate
  • Kidney Transplantation/mortality
  • Male
  • Middle Aged
  • Phosphates/blood
  • Postoperative Complications/blood
  • Predictive Value of Tests
  • Prevalence
  • Risk Factors

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