Mortality in CKD Linked to Hormone
High levels of a hormone that regulates phosphorus metabolism are associated with an increased risk of death in people with chronic kidney disease, researchers reported.
Surprisingly, elevated fibroblast growth factor 23 (or FGF-23) was more strongly associated with mortality than traditional cardiovascular disease- and chronic kidney disease-specific risk factors, according to Myles Wolf, MD, of the University of Miami's Miller School of Medicine in Miami, and colleagues.
The finding suggests that FGF-23 may be a novel risk factor for mortality in chronic kidney disease, Wolf and colleagues stated in the June 15 issue of the Journal of The American Medical Association.
On the other hand, the hormone was only linked with end-stage renal disease in people whose kidney function was relatively preserved at baseline, the researchers reported.
A high level of FGF-23 is known to be associated with mortality in patients with end-stage renal disease, Wolf and colleagues noted, but little is known about its link to adverse outcomes in patients with earlier kidney disease.
To help clarify the issue, they analyzed outcomes in the prospective Chronic Renal Insufficiency Cohort, whose 3,879 participants, enrolled between June 2003 and September 2008, had chronic kidney disease stages 2 through 4.
During a median follow up of 3.5 years, 266 participants died and 410 reached end-stage renal disease, for rates per 1,000 person-years of 20.3 and 33, respectively.
At baseline, the average estimated glomerular filtration rate was 42.8 ml/minute/1.73 m of body surface, the researchers reported.
And the median baseline FGF-23 level was 145.5 reference units/ml, more than three times the median of 43 reference units/ml that was seen in a population with a low prevalence of chronic kidney disease, Wolf and colleagues found.
The researchers divided participants into quartiles based on FGF-23 levels and found that the risk of death, in a fully adjusted model, rose as the hormone levels rose. Specifically, compared with the lowest quartile: The hazard ratio (HR) was 1.3 for the second quartile, but the 95% confidence interval ranged from 0.8 to 2.2. The HR was 2.0 for the third quartile with a 95% confidence interval from 1.2 to 3.3. The HR was 3.0 for the third quartile, with a 95% confidence interval from 1.8 to 5.1.
Traditional renal risk factors such as the estimated glomerular filtration rate did not influence the relationship, while including cardiovascular risk factors only changed it "minimally," the researchers reported.
What Causes Low Phosphorus - News
Explain that high levels of a hormone (fibroblast growth factor 23) that regulates phosphorus metabolism are associated with an increased risk of death in people with chronic kidney disease.
Several studies have investigated the effects of reducing the amount of phosphorus in salmon feed. The results have shown that a combination of low levels of phosphorus and continuous light, which is used to increase growth rates can lead to bone
As great of a nuisance as bacteria is the massive algae produced by phosphorus, a nutrient in both synthetic products and animal manure that is applied to farms, as well as the fertilizers applied to lawns, golf courses, and other types of land.
Going the chemical route with fertilizer also can cause problems, Brawner says. He describes chemical fertilizers made from petroleum as a "sugar approach" to gardening. "So you get your nitrogen, potassium and phosphorus, but they're usually deficient
Flavored milk contains the same nine essential nutrients as white milk – calcium, potassium, phosphorus, protein, vitamins A, D and B12, riboflavin and niacin. In schools, low-fat chocolate milk is the most popular milk choice and kids drink less milk
Phosphorus Imbalance | Definition | Description | Causes and ...
Definition
Phosphorus imbalance refers to conditions in which the element phosphorus is present in the body at too high a level (hyperphosphatemia) or too low a level (hypophosphatemia).
Description
Almost all of the phosphorus in the body occurs as phosphate ( phosphorus combined with four oxygen atoms), and most of the body's phosphate (85%) is located in the skeletal system, where it combines with calcium to give bones their hardness. The remaining amount (15%) exists in the cells of the body, where it plays an important role in the formation of key nucleic acids, such as DNA, and in the process by which the body turns food into energy (metabolism). The body regulates phosphate levels in the blood through the controlled release of parathyroid hormone (PTH) from the parathyroid gland and calcitonin from the thyroid gland. PTH keeps phosphate levels from becoming too high by stimulating the excretion of phosphate in urine and causing the release of calcium from bones (phosphate blood levels are inversely proportional to calcium blood levels). Calcitonin keeps phosphate blood levels in check by moving phosphates out of the blood and into the bone matrix to form a mineral salt with calcium.
Most phosphorus imbalances develop gradually and are the result of other conditions or disorders, such as malnutrition, poor kidney function, or a malfunctioning gland.
Causes and symptoms
Hypophosphatemia
Hypophosphatemia (low blood phosphate) has various causes. Hyperparathyroidism, a condition in which the parathyroid gland produces too much PTH, is one primary cause. Poor kidney function, in which the renal tubules do not adequately reabsorb phosphorus , can result in hypophosphatemia, as can overuse of diuretics, such as theophylline, and antacids containing aluminum hydroxide.
What Causes Low Phosphorus - Bookshelf
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