Table 3.
Risk of ESRD or death during the AASK trial and cohort by quartiles of mineral metabolites
| Incidence per 1000 person-yr | HR | ||||||
|---|---|---|---|---|---|---|---|
| Age, Sex, and Randomizationa (n=809) | +GFR (n=806) | +UPCR (n=782) | Multivariableb (n=780) | +Preceding GFR Slope (n=773) | +Mineral Metabolites (n=772) | ||
| FGF23 (pg/ml) | |||||||
| ≤30.7 | 26.2 | Ref | Ref | Ref | Ref | Ref | Ref |
| 30.8–44.2 | 47.4 | 1.80 (1.34, 2.43) | 1.40 (0.98, 1.99) | 1.57 (1.07, 2.29) | 1.47 (0.98, 2.20) | 1.44 (0.96, 2.15) | 1.49 (0.94, 2.36) |
| 44.3–64.3 | 70.0 | 2.71 (1.79, 4.09) | 1.58 (0.99, 2.52) | 1.64 (1.05, 2.56) | 1.67 (1.04, 2.69) | 1.65 (1.02, 2.68) | 1.78 (1.04, 3.06) |
| ≥64.4 | 141.3 | 5.57 (3.94, 7.89) | 2.17 (1.39, 3.39) | 2.24 (1.43, 3.51) | 2.24 (1.39, 3.60) | 2.22 (1.37, 3.58) | 2.26 (1.34, 3.83) |
| P trend | — | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 | <0.01 |
| PTH (pg/ml) | |||||||
| ≤24.0 | 35.6 | 0.93 (0.68, 1.27) | 1.22 (0.92, 1.63) | 1.25 (0.88, 1.77) | 1.24 (0.88, 1.76) | 1.21 (0.86, 1.72) | 1.17 (0.80, 1.72) |
| 24.1–37.0 | 38.6 | Ref | Ref | Ref | Ref | Ref | Ref |
| 37.1–60.7 | 71.0 | 1.84 (1.33, 2.54) | 1.25 (0.91, 1.72) | 1.22 (0.87, 1.70) | 1.25 (0.90, 1.75) | 1.24 (0.89, 1.74) | 1.05 (0.72, 1.52) |
| ≥60.8 | 138.2 | 3.72 (2.71, 5.10) | 1.67 (1.25, 2.24) | 1.66 (1.17, 2.37) | 1.65 (1.17, 2.32) | 1.64 (1.16, 2.32) | 1.35 (0.91, 2.01) |
| P trend | — | <0.01 | 0.01 | 0.01 | 0.01 | 0.01 | 0.26 |
| Serum phosphate (mg/dl) | |||||||
| ≤3.1 | 50.7 | 1.03 (0.74, 1.42) | 1.17 (0.86, 1.61) | 1.20 (0.86, 1.68) | 1.13 (0.79, 1.62) | 1.12 (0.78, 1.60) | 1.14 (0.77, 1.68) |
| 3.2–3.5 | 49.2 | Ref | Ref | Ref | Ref | Ref | Ref |
| 3.6–3.9 | 63.4 | 1.31 (0.99, 1.75) | 0.95 (0.63, 1.42) | 0.90 (0.57, 1.41) | 0.95 (0.61, 1.46) | 0.93 (0.60, 1.43) | 0.94 (0.63, 1.41) |
| ≥4.0 | 112.7 | 2.37 (1.86, 3.02) | 1.51 (1.12, 2.04) | 1.43 (1.15, 1.78) | 1.46 (1.19, 1.80) | 1.44 (1.18, 1.76) | 1.39 (1.15, 1.67) |
| P trend | — | <0.01 | 0.09 | 0.21 | 0.08 | 0.09 | 0.19 |
| 25-hydroxyvitamin D (ng/dl)c | |||||||
| Quartile 1 | 69.8 | 1.41 (1.03, 1.92) | 1.61 (1.16, 2.21) | 1.36 (0.97, 1.90) | 1.25 (0.88, 1.78) | 1.23 (0.87, 1.75) | 1.39 (0.89, 2.18) |
| Quartile 2 | 71.8 | 1.42 (1.15, 1.75) | 1.70 (1.31, 2.21) | 1.49 (0.97, 2.29) | 1.50 (0.98, 2.27) | 1.46 (0.96, 2.23) | 1.55 (0.97, 2.46) |
| Quartile 3 | 66.1 | 1.33 (1.02, 1.73) | 1.46 (1.07, 1.98) | 1.28 (0.93, 1.78) | 1.27 (0.96, 1.68) | 1.26 (0.95, 1.67) | 1.35 (1.01, 1.81) |
| Quartile 4 | 49.8 | Ref | Ref | Ref | Ref | Ref | Ref |
| P trend | — | 0.02 | <0.01 | 0.08 | 0.20 | 0.23 | 0.16 |
Adjusted for age, sex, and randomized treatment assignment and clustered by clinical center. +GFR, additionally adjusted for 125I-iothalamate GFR; +UPCR, additionally adjusted for UPCR.
Multivariable model adjusted for age, sex, randomized treatment assignment, 125I-iothalamate GFR, UPCR, income, prior heart disease, smoking, serum albumin, and categories of body mass index. This model is the primary model of interest. + preceding GFR slope, additionally adjusted for the slope of 125I-iothalamate GFR in the 9 months preceding measurement of mineral metabolites; + mineral metabolites, additionally adjusted for serum calcium, phosphate, PTH, FGF23 and 25-hydroxyvitamin D.
Ranges for 25-hydroxyvitamin D quartiles (Q) are season-specific as follows: winter (Q1, ≤8.4; Q2, 8.5–10.9; Q3, 11.0–16.2; Q4, ≥16.3 ng/ml); spring (Q1, ≤7.9; Q2, 8.0–10.9; Q3, 11.0–16.5; Q4, ≥16.6 ng/ml); summer (Q1, ≤10.0; Q2, 10.1–15.2; Q3, 15.3–20.6; Q4, ≥20.7 ng/ml); and fall (Q1, ≤11.0; Q2, 11.1–14.7; Q3, 14.8–22.8; Q4, ≥22.9 ng/ml).