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. 2011 Nov;6(11):2712–2721. doi: 10.2215/CJN.06190611

Table 3.

Hazard ratio (95% confidence intervals) of posttransplant death (all-cause or cardiovascular) or graft failure or delayed graft function comparing pretransplant serum phosphorus categories (3.5 to <5.5 mg/dl the reference) using Cox regression and logistic regression analyses in 9384 dialysis patients who underwent renal transplantation and were observed for up to 6 years (July 2001 through June 2007)

Pretransplant Serum Phosphorus Level (mg/dl) Unadjusted (n = 9384)
+Case-mix Adjusteda (n = 8469)
+MICS Adjustedb (n = 8073)
+Transplant Data Adjustedc (n = 4830)
HR (95% CI) P HR (95% CI) P HR (95% CI) P HR (95% CI) P
A. Graft failure censored all-cause death
    <3.5 1.66 (1.18 to 2.33) 0.004 1.61 (1.10 to 2.36) 0.01 1.46 (0.98 to 2.17) 0.06 1.26 (0.77 to 2.04) 0.36
    3.5 to <5.5 1.00 N/A 1.00 N/A 1.00 N/A 1.00 N/A
    5.5 to <7.5 0.87 (0.74 to 1.02) 0.09 0.96 (0.81 to 1.14) 0.62 0.97 (0.81 to 1.16) 0.75 0.89 (0.72 to 1.10) 0.29
    7.5 to <9.5 0.73 (0.57 to 0.93) 0.01 0.92 (0.70 to 1.21) 0.55 0.94 (0.70 to 1.25) 0.67 1.09 (0.77 to 1.52) 0.84
    ≥9.5 1.32 (0.85 to 2.03) 0.21 2.25 (1.41 to 3.59) 0.001 2.21 (1.36 to 3.59) 0.001 2.44 (1.28 to 4.65) 0.007
B. Graft failure censored cardiovascular death
    <3.5 2.39 (1.30 to 4.42) 0.005 2.40 (1.22 to 4.71) 0.01 2.18 (1.10 to 4.32) 0.03 1.72 (0.71 to 4.19) 0.23
    3.5 to <5.5 1.00 N/A 1.00 N/A 1.00 N/A 1.00 N/A
    5.5 to <7.5 0.98 (0.70 to 1.36) 0.89 1.00 (0.71 to 1.42) 0.99 1.04 (0.72 to 1.52) 0.81 1.15 (0.74 to 1.78) 0.54
    7.5 to <9.5 0.93 (0.58 to 1.49) 0.75 1.04 (0.67 to 1.48) 0.81 1.25 (0.73 to 2.13) 0.42 1.14 (0.56 to 2.33) 0.72
    ≥9.5 2.12 (1.02 to 4.41) 0.04 2.66 (1.18 to 6.01) 0.02 2.61 (1.07 to 6.38) 0.04 3.63 (1.13 to 11.64) 0.04
C. All-cause death censored graft failure
    <3.5 1.33 (0.90 to 1.96) 0.15 1.19 (0.77 to 1.84) 0.45 1.18 (0.76 to 1.83) 0.47 1.06 (0.58 to 1.92) 0.85
    3.5 to <5.5 1.00 N/A 1.00 N/A 1.00 N/A 1.00 N/A
    5.5 to <7.5 1.02 (0.87 to 1.20) 0.79 0.94 (0.79 to 1.11) 0.46 0.98 (0.82 to 1.17) 0.79 1.10 (0.88 to 1.39) 0.40
    7.5 to <9.5 1.32 (1.07 to 1.61) 0.01 1.10 (0.88 to 1.37) 0.43 1.26 (0.96 to 1.55) 0.10 1.42 (1.04 to 1.95) 0.03
    ≥9.5 2.16 (1.51 to 3.08) <0.001 2.06 (1.42 to 2.99) <0.001 2.24 (1.50 to 3.35) <0.001 2.36 (1.33 to 4.17) 0.003
D. Combined all-cause death or graft failure
    <3.5 1.46 (1.11 to 1.92) 0.01 1.42 (1.05 to 1.93) 0.02 1.32 (0.97 to 1.81) 0.08 1.13(0.75 to 1.70) 0.56
    3.5 to <5.5 1.00 N/A 1.00 N/A 1.00 N/A 1.00 N/A
    5.5 to <7.5 0.95 (0.84 to 1.07) 0.42 0.94 (0.83 to 1.07) 0.35 0.96 (0.84 to 1.10) 0.57 0.95 (0.81 to 1.13) 0.59
    7.5 to <9.5 1.04 (0.89 to 1.23) 0.61 1.03 (0.86 to 1.23) 0.77 1.09 (0.90 to 1.32) 0.37 1.11 (0.87 to 1.42) 0.40
    ≥9.5 1.71 (1.28 to 2.29) <0.001 2.08 (1.52 to 2.83) <0.001 2.15 (1.54 to 2.98) <0.001 1.99 (1.23 to 3.21) 0.01
Unadjusted (n = 8924) +Case-mix Adjusteda (n = 8069) +MICS Adjustedb (n = 7692) +Transplant Data Adjustedc (n = 4830)
OR (95% CI) P OR (95% CI) P OR (95% CI) P OR (95% CI) P
E. Delayed graft function
    <3.5 1.05 (0.77 to 1.43) 0.76 0.85 (0.59 to 1.21) 0.36 0.85 (0.59 to 1.23) 0.39 0.80 (0.53 to 1.22) 0.31
    3.5 to <5.5 1.00 N/A 1.00 N/A 1.00 N/A 1.00 N/A
    5.5 to <7.5 1.04 (0.92 to 1.16) 0.55 1.06 (0.93 to 1.19) 0.39 1.00 (0.88 to 1.14) 0.97 1.01 (0.87 to 1.17) 0.90
    7.5 to <9.5 1.15 (0.98 to 1.35) 0.09 1.21 (1.01 to 1.44) 0.04 1.08 (0.89 to 1.31) 0.44 1.06 (0.84 to 1.33) 0.63
    ≥9.5 0.99 (0.69 to 1.42) 0.95 1.23 (0.83 to 1.82) 0.31 1.03 (0.67 to 1.57) 0.90 1.02 (0.60 to 1.73) 0.93

Abbreviations: HR, hazard ratio; CI, confidence interval; N/A, not applicable; OR, odds ratio.

a

Adjusted for age, gender, recipient race-ethnicity, diabetes mellitus, dialysis vintage, primary insurance, marital status, standardized mortality ratio of the dialysis clinic during entry quarter, dialysis dose as indicated by Kt/V (single pool), presence or absence of a hemodialysis catheter, and residual renal function during the entry quarter and eight comorbidities.

b

Adjusted for all of the covariates plus body mass index, normalized protein nitrogen appearance, serum or blood concentrations of total iron binding capacity, ferritin, calcium, bicarbonate, peripheral white blood cell count, lymphocyte percentage, and albumin.

c

Adjusted for all of the above plus donor type, donor age, donor gender, panel reactive antibody titer (last value prior to transplant), number of HLA mismatches, cold ischemia time, delayed graft function (except when delayed graft function was a dependent variable in our logistic regression models), and extended donor criteria.