TY - JOUR
T1 - Dietary Phosphorus, Its Sources, and Mortality in Adults on Haemodialysis
T2 - The DIET-HD Study
AU - Su, Guobin
AU - Saglimbene, Valeria
AU - Wong, Germaine
AU - Bernier-Jean, Amélie
AU - Carrero, Juan Jesus
AU - Natale, Patrizia
AU - Ruospo, Marinella
AU - Hegbrant, Jorgen
AU - Craig, Jonathan C.
AU - Strippoli, Giovanni F. M.
PY - 2022/10
Y1 - 2022/10
N2 - 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.
AB - 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.
KW - cohort
KW - DIET-HD
KW - haemodialysis
KW - mortality
KW - phosphorus
KW - plant-base
UR - http://www.scopus.com/inward/record.url?scp=85139854977&partnerID=8YFLogxK
U2 - 10.3390/nu14194064
DO - 10.3390/nu14194064
M3 - Article
C2 - 36235716
AN - SCOPUS:85139854977
SN - 2072-6643
VL - 14
JO - Nutrients
JF - Nutrients
IS - 19
M1 - 4064
ER -