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ツチヤ ケン
Tsuchiya Ken
土谷 健 所属 医学部 医学科（東京女子医科大学病院） 職種 特任教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Association of hyperphosphatemia with renal prognosis in patients with autosomal dominant polycystic kidney disease. |
| 掲載誌名 | 正式名：Clinical and experimental nephrology 略 称：Clin Exp Nephrol ISSNコード：14377799/13421751 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online |
| 著者・共著者 | Nitta Kosaku, Kataoka Hiroshi, Manabe Shun, Makabe Shiho, Akihisa Taro, Ushio Yusuke, Seki Momoko, Tsuchiya Ken, Hoshino Junichi, Mochizuki Toshio |
| 発行年月 | 2024/09/25 |
| 概要 | BACKGROUND:Serum phosphate (P) levels are generally lower in autosomal dominant polycystic kidney disease (ADPKD) than in other kidney disorders, potentially masking the clinical significance of hyperphosphatemia. This study aimed to determine if serum P levels can predict renal outcomes in ADPKD patients.METHODS:We included 235 patients with ADPKD who were not taking drugs to treat hyperphosphatemia. Survival analysis was performed for the renal outcome of a 50% reduction in estimated glomerular filtration rate or initiation of renal replacement therapy.RESULTS:Multivariable Cox regression analyses revealed that serum P (1 mg/dL increase, HR = 2.03, P < 0.0001) was a significant risk factor for kidney disease progression. Similarly, hyperphosphatemia (P > 3.5 mg/dL, HR = 2.05; P > 4.0 mg/dL, HR = 1.90; P > 4.5 mg/dL, HR = 2.78; P > 5.0 mg/dL, HR = 27.22) was significantly associated with renal prognosis. Kaplan-Meier analysis showed significantly lower kidney survival rates in patients with P > 3.5 mg/dL than in those without hyperphosphatemia (log-rank test, P < 0.0001), and similar Kaplan-Meier analysis results were found for P > 4.0 mg/dL, P > 4.5 mg/dL, and P > 5.0 mg/dL. The 2 year kidney survival rate for ADPKD patients with P > 3.5 mg/dL was 66.7% overall and 41.4% in those with stage 4-5 CKD. For patients with P > 4.0 mg/dL, the survival rate dropped to 46.8% overall and 28.2% in those with stage 4-5 CKD, indicating a very poor prognosis.CONCLUSION:Hyperphosphatemia was associated with renal prognosis in patients with ADPKD. In these patients, attention should be paid to even mild serum P elevation of > 3.5 or > 4.0 mg/dL. |
| DOI | 10.1007/s10157-024-02568-6 |
| PMID | 39322826 |