Table 4.
Association of Serum Phosphorus, Urine Phosphorus/Creatinine Ratio, and Urinary Fractional Excretion of Phosphorus with Cardiovascular Mortality
| Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | |
|---|---|---|---|---|
| Serum Phosphorus | ||||
| Range (mg/dL) | <3.0 | 3.0–3.2 | 3.3–3.5 | ≥3.6 |
| Events/Total (annual event rate) | 31/415 (1%) | 29/351 (1%) | 28/304 (1%) | 32/255 (2%) |
| Model 1; HR (95% CI) | 1.00 (reference) | 1.16 (0.70–1.93) | 1.32 (0.79–2.20) | 1.87 (1.14–3.07) |
| Model 2; HR (95% CI) | 1.00 (reference) | 1.13 (0.68–1.88) | 1.24 (0.74–2.08) | 1.80 (1.09–2.95) |
| Model 3; HR (95% CI) | 1.00 (reference) | 1.14 (0.68–1.92) | 1.12 (0.66–1.90) | 1.56 (0.93–2.62) |
| Urine Phosphorus/Creatinine | ||||
| Range (mg/mg) | <0.33 | 0.33–0.42 | 0.43–0.54 | ≥0.55 |
| Events/Total (annual event rate) | 27/332 (1%) | 22/331 (1%) | 30/332 (1%) | 41/330 (1%) |
| Model 1; HR (95% CI) | 1.00 (reference) | 0.85 (0.48–1.49) | 1.05 (0.62–1.77) | 1.48 (0.91–2.40) |
| Model 2; HR (95% CI) | 1.00 (reference) | 0.82 (0.47–1.45) | 0.97 (0.57–1.63) | 1.45 (0.89–2.35) |
| Model 3; HR (95% CI) | 1.00 (reference) | 0.83 (0.47–1.46) | 0.95 (0.56–1.62) | 1.18 (0.72–1.95) |
| Urinary Fractional Excretion of Phosphorus | ||||
| Range (%) | <10 | 10–13 | 14–17 | ≥18 |
| Events/Total (annual event rate) | 24/332 (1%) | 23/331 (1%) | 26/332 (1%) | 47/330 (2%) |
| Model 1; HR (95% CI) | 1.00 (reference) | 0.93 (0.52–1.65) | 1.06 (0.61–1.85) | 1.53 (0.93–2.53) |
| Model 2; HR (95% CI) | 1.00 (reference) | 0.85 (0.48–1.51) | 0.85 (0.48–1.50) | 0.93 (0.52–1.63) |
| Model 3; HR (95% CI) | 1.00 (reference) | 0.92 (0.52–1.64) | 0.82 (0.46–1.46) | 0.84 (0.47–1.49) |
Model 1 = age and race adjusted
Model 2 = Model 1 plus eGFR and microalbuminuria (yes/no)
Model 3 = Model 2 plus prevalent CVD, diabetes, systolic blood pressure, blood pressure medication use, tobacco use (current, former, never), body mass index, total cholesterol, HDL cholesterol, and lipid medication use.