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Dietary Phosphorus, Its Sources, and Mortality in Adults on Haemodialysis : The DIET-HD Study

Su, Guobin ; Saglimbene, Valeria ; Wong, Germaine ; Bernier-Jean, Amélie ; Carrero, Juan Jesus ; Natale, Patrizia ; Ruospo, Marinella ; Hegbrant, Jorgen LU ; Craig, Jonathan C. and Strippoli, Giovanni F.M. (2022) In Nutrients 14(19).
Abstract

Dietary phosphorus restrictions are usually recommended for people on haemodialysis, although its impact on patient-relevant outcomes is uncertain. We aimed to evaluate the association between total phosphorus intake and its sources with mortality in haemodialysis. Phosphorus intake was ascertained within the DIET-HD study in 8110 adults on haemodialysis. Adjusted Cox regression analyses were conducted to evaluate the association between the total and source-specific phosphorus (plant-, animal-, or processed and other sources) with mortality. During a median 3.8 years of follow-up, there were 2953 deaths, 1160 cardiovascular-related. The median phosphorus intake was 1388 mg/day. Every standard deviation (SD) (896 mg/day) increase in... (More)

Dietary phosphorus restrictions are usually recommended for people on haemodialysis, although its impact on patient-relevant outcomes is uncertain. We aimed to evaluate the association between total phosphorus intake and its sources with mortality in haemodialysis. Phosphorus intake was ascertained within the DIET-HD study in 8110 adults on haemodialysis. Adjusted Cox regression analyses were conducted to evaluate the association between the total and source-specific phosphorus (plant-, animal-, or processed and other sources) with mortality. During a median 3.8 years of follow-up, there were 2953 deaths, 1160 cardiovascular-related. The median phosphorus intake was 1388 mg/day. Every standard deviation (SD) (896 mg/day) increase in total phosphorus was associated with higher all-cause mortality [hazard ratio (HR), 1.16; 95% confidence intervals (CI), 1.06–1.26] and cardiovascular mortality (HR, 1.18; 95% CI, 1.03–1.36). Every SD (17%) increase in the proportion of phosphorus from plant sources was associated with lower all-cause mortality (HR, 0.95; 95% CI, 0.90–0.99). Every SD (9%) increase in the proportion of phosphorus from the processed and other sources was associated with higher all-cause mortality (HR, 1.06; 95% CI, 1.02–1.10). A higher total phosphorus intake was associated with increased all-cause and cardiovascular death. This association is driven largely by the phosphorus intake from processed food. Plant based phosphorus was associated with lower all-cause mortality.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cohort, DIET-HD, haemodialysis, mortality, phosphorus, plant-base
in
Nutrients
volume
14
issue
19
article number
4064
publisher
MDPI AG
external identifiers
  • scopus:85139854977
  • pmid:36235716
ISSN
2072-6643
DOI
10.3390/nu14194064
language
English
LU publication?
yes
id
edd41763-fd01-45a4-b1ad-4a9b5edbb1d3
date added to LUP
2022-12-14 15:49:14
date last changed
2024-06-23 17:13:32
@article{edd41763-fd01-45a4-b1ad-4a9b5edbb1d3,
  abstract     = {{<p>Dietary phosphorus restrictions are usually recommended for people on haemodialysis, although its impact on patient-relevant outcomes is uncertain. We aimed to evaluate the association between total phosphorus intake and its sources with mortality in haemodialysis. Phosphorus intake was ascertained within the DIET-HD study in 8110 adults on haemodialysis. Adjusted Cox regression analyses were conducted to evaluate the association between the total and source-specific phosphorus (plant-, animal-, or processed and other sources) with mortality. During a median 3.8 years of follow-up, there were 2953 deaths, 1160 cardiovascular-related. The median phosphorus intake was 1388 mg/day. Every standard deviation (SD) (896 mg/day) increase in total phosphorus was associated with higher all-cause mortality [hazard ratio (HR), 1.16; 95% confidence intervals (CI), 1.06–1.26] and cardiovascular mortality (HR, 1.18; 95% CI, 1.03–1.36). Every SD (17%) increase in the proportion of phosphorus from plant sources was associated with lower all-cause mortality (HR, 0.95; 95% CI, 0.90–0.99). Every SD (9%) increase in the proportion of phosphorus from the processed and other sources was associated with higher all-cause mortality (HR, 1.06; 95% CI, 1.02–1.10). A higher total phosphorus intake was associated with increased all-cause and cardiovascular death. This association is driven largely by the phosphorus intake from processed food. Plant based phosphorus was associated with lower all-cause mortality.</p>}},
  author       = {{Su, Guobin and Saglimbene, Valeria and Wong, Germaine and Bernier-Jean, Amélie and Carrero, Juan Jesus and Natale, Patrizia and Ruospo, Marinella and Hegbrant, Jorgen and Craig, Jonathan C. and Strippoli, Giovanni F.M.}},
  issn         = {{2072-6643}},
  keywords     = {{cohort; DIET-HD; haemodialysis; mortality; phosphorus; plant-base}},
  language     = {{eng}},
  number       = {{19}},
  publisher    = {{MDPI AG}},
  series       = {{Nutrients}},
  title        = {{Dietary Phosphorus, Its Sources, and Mortality in Adults on Haemodialysis : The DIET-HD Study}},
  url          = {{http://dx.doi.org/10.3390/nu14194064}},
  doi          = {{10.3390/nu14194064}},
  volume       = {{14}},
  year         = {{2022}},
}