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摘要
Background Evidence on the association between elevated admission serum phosphate and risk of in-hospital acute kidney injury (AKI) is limited. The aim of this study was to assess the risk of AKI in hospitalized patients stratified by admission serum phosphate level.
Methods This is a single-center retrospective study conducted at a tertiary referral hospital. All hospitalized adult patients who had admission phosphate measurement available between January and December 2013 were enrolled. Admission phosphate was categorized into 6 groups (< 2.4, 2.4-2.9, 2.9-3.4, 3.4-3.9, 3.9-4.4, and >= 4.4 mg/dl). The primary outcome was in-hospital AKI occurring after hospital admission. Logistic regression analysis was performed to obtain the odds ratio of AKI for various admission phosphate strata using the phosphate 2.4-2.9 mg/dl level (lowest incidence of AKI) as the reference group.
Results After excluding patients with end-stage renal disease (ESRD), without serum phosphate measurement, and those with AKI at time of admission, a total of 5036 patients were studied. Phosphate levels of < 2.4 and >= 4.4 mg/dl were found in 458 (9.1%) and 585 (11.6%) patients, respectively. In-hospital AKI occurred in 595 (11.8%) patients. The incidence of AKI among patients with admission phosphate < 2.4, 2.4-2.9, 2.9-3.4, 3.4-3.9, 3.9-4.4, and >= 4.4 mg/dl was 10.5, 9.5, 11.8, 10.0, 12.8, and 17.9%, respectively. After adjusting for potential confounders, admission serum phosphate > 4.4 mg/dl was associated with an increased risk of developing AKI with an odds ratio of 1.72 (95% confidence interval 1.20-2.47), whereas admission serum phosphate levels < 4.4 mg/dl were not associated with development of AKI during hospitalization.
Conclusion Elevated admission phosphate is associated with an increased risk for in-hospital AKI.
- 出版日期2018-4
