Phosphate Levels and Blood Pressure in Incident Hemodialysis Patients: A Longitudinal Study

Cindy Xin Huang, Laura C. Plantinga, Nancy E. Fink, Michal L. Melamed, Josef Coresh, Neil R. Powe

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

An elevated serum phosphate level in hemodialysis patients has been associated with mineral deposition in blood vessels. We studied a possible physiologic consequence of hyperphosphatemia by examining the relation between serum phosphate levels and blood pressure in 707 incident hemodialysis patients from 75 clinics who were enrolled in a prospective cohort study. We conducted cross-sectional and longitudinal multiple linear regression analyses, adjusting for demographics, medical history, and laboratory factors. In cross-sectional analyses at baseline, elevated serum phosphate was associated with higher predialysis systolic blood pressure (SBP) and pulse pressure (PP) at the start of dialysis; each 1 mg/dL higher phosphate level was associated with 1.77 mm Hg higher SBP. In multivariable adjusted longitudinal analyses, for each 1 mg/dL higher serum phosphate at baseline, SBP was higher at 3 months, 1.36 mm Hg (P = .005); 6 months, 1.13 mm Hg (P = .035); 12 months, 1.65 mm Hg (P = .008); 18 months, 1.44 mm Hg (P = .031); and 27 months, 2.54 mm Hg (P = .002). PP was higher at 3 months, 0.80 mm Hg (P = .027); 6 months, 0.91 mm Hg (P = .022); 12 months, 1.45 mm Hg (P < .001); 18 months, 1.06 mm Hg (P = .026); and 27 months, 1.37 mm Hg (P = .020). This study suggests that serum phosphate level is strongly and independently associated with blood pressure in hemodialysis patients. The effect of rigorous control of serum phosphate levels on arterial stiffness and blood pressure should be studied in clinical trials.

Original languageEnglish (US)
Pages (from-to)321-331
Number of pages11
JournalAdvances in Chronic Kidney Disease
Volume15
Issue number3
DOIs
StatePublished - Jul 2008
Externally publishedYes

Fingerprint

Longitudinal Studies
Renal Dialysis
Phosphates
Blood Pressure
Serum
Hyperphosphatemia
Vascular Stiffness
Minerals
Blood Vessels
Dialysis
Linear Models
Arterial Pressure
Cohort Studies
Cross-Sectional Studies
Regression Analysis
Demography
Clinical Trials
Prospective Studies
Hypertension

Keywords

  • Blood pressure
  • Hemodialysis
  • Phosphate

ASJC Scopus subject areas

  • Nephrology

Cite this

Phosphate Levels and Blood Pressure in Incident Hemodialysis Patients : A Longitudinal Study. / Huang, Cindy Xin; Plantinga, Laura C.; Fink, Nancy E.; Melamed, Michal L.; Coresh, Josef; Powe, Neil R.

In: Advances in Chronic Kidney Disease, Vol. 15, No. 3, 07.2008, p. 321-331.

Research output: Contribution to journalArticle

Huang, Cindy Xin ; Plantinga, Laura C. ; Fink, Nancy E. ; Melamed, Michal L. ; Coresh, Josef ; Powe, Neil R. / Phosphate Levels and Blood Pressure in Incident Hemodialysis Patients : A Longitudinal Study. In: Advances in Chronic Kidney Disease. 2008 ; Vol. 15, No. 3. pp. 321-331.
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