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Dietary Phosphorus, Its Sources, and Mortality in Adults on Haemodialysis: The DIET-HD Study

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机构: [1]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510000, China [2]Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Stockholm, Sweden [3]Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden [4]European Renal Nutrition Working Group of the European Renal Association-European Dialysis Transplant Association (ERA-EDTA), 43126 Parma, Italy [5]Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, Sydney, NSW 2006, Australia [6]Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124 Bari, Italy [7]Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, NSW 2145, Australia [8]Division of Nephrology, CIUSSS du Nord-de-l’Île-de-Montréal, Faculty of Medicine, Université de Montréal, Montréal, QC 2900, Canada [9]Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy [10]Division of Nephrology, Department of Clinical Sciences, Lund University, 22100 Lund, Sweden [11]College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
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关键词: phosphorus plant-base mortality haemodialysis cohort DIET-HD

摘要:
Dietary phosphorus restrictions are usually recommended for people on haemodialysis, although its impact on patient-relevant outcomes is uncertain. We aimed to evaluate the association between total phosphorus intake and its sources with mortality in haemodialysis. Phosphorus intake was ascertained within the DIET-HD study in 8110 adults on haemodialysis. Adjusted Cox regression analyses were conducted to evaluate the association between the total and source-specific phosphorus (plant-, animal-, or processed and other sources) with mortality. During a median 3.8 years of follow-up, there were 2953 deaths, 1160 cardiovascular-related. The median phosphorus intake was 1388 mg/day. Every standard deviation (SD) (896 mg/day) increase in total phosphorus was associated with higher all-cause mortality [hazard ratio (HR), 1.16; 95% confidence intervals (CI), 1.06-1.26] and cardiovascular mortality (HR, 1.18; 95% CI, 1.03-1.36). Every SD (17%) increase in the proportion of phosphorus from plant sources was associated with lower all-cause mortality (HR, 0.95; 95% CI, 0.90-0.99). Every SD (9%) increase in the proportion of phosphorus from the processed and other sources was associated with higher all-cause mortality (HR, 1.06; 95% CI, 1.02-1.10). A higher total phosphorus intake was associated with increased all-cause and cardiovascular death. This association is driven largely by the phosphorus intake from processed food. Plant based phosphorus was associated with lower all-cause mortality.

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大类 | 2 区 医学
小类 | 2 区 营养学
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大类 | 2 区 医学
小类 | 2 区 营养学
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Q1 NUTRITION & DIETETICS
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Q1 NUTRITION & DIETETICS

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第一作者机构: [1]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510000, China [2]Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Stockholm, Sweden [3]Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden [4]European Renal Nutrition Working Group of the European Renal Association-European Dialysis Transplant Association (ERA-EDTA), 43126 Parma, Italy
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通讯机构: [5]Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, Sydney, NSW 2006, Australia [6]Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124 Bari, Italy
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