ArticleKidney international2016
Relationship of dietary phosphate intake with risk of end-stage renal disease and mortality in chronic kidney disease stages 3-5: The Modification of Diet in Renal Disease Study.
Article in Kidney international, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 80 citations in OpenAlex.
- Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort Studies.Clinical journal of the American Society of Nephrology : CJASN · 2017Pooled it
- The Percentage of Dietary Phosphorus Excreted in the Urine Varies by Dietary Pattern in a Randomized Feeding Study in Adults.The Journal of nutrition · 2019Trial
- High phosphorus intake and gut-related parameters - results of a randomized placebo-controlled human intervention study.Nutrition journal · 2018Trial
- Hyperphosphatemia and hs-CRP Initiate the Coronary Artery Calcification in Peritoneal Dialysis Patients.BioMed research international · 2017Trial
- The Phosphate/Urea Nitrogen Ratio in Urine-A Method to Assess the Relative Intake of Inorganic Phosphate.Nutrients · 2025Article
- Review
- Urine anion and osmolality gaps in the comprehensive evaluation of acid base balance across different levels of kidney function.Scientific reports · 2025Article
- The true cost of phosphate control in chronic kidney disease.Clinical kidney journal · 2025Article
- From premature birth to premature kidney disease: does accelerated aging play a role?Pediatric nephrology (Berlin, Germany) · 2024Review
- The Protein-Independent Role of Phosphate in the Progression of Chronic Kidney Disease.Toxins · 2021Article
- Review
- The Importance of Phosphate Control in Chronic Kidney Disease.Nutrients · 2021Review
- Focus on the Possible Role of Dietary Sodium, Potassium, Phosphate, Magnesium, and Calcium on CKD Progression.Journal of clinical medicine · 2021Review
- Dietary Phosphorus as a Marker of Mineral Metabolism and Progression of Diabetic Kidney Disease.Nutrients · 2021Review
- Assessment of Inorganic Phosphate Intake by the Measurement of the Phosphate/Urea Nitrogen Ratio in Urine.Nutrients · 2021Article
- Binder Blunder in CKD.Journal of the American Society of Nephrology : JASN · 2020Article
- Nutritional management in patients with chronic kidney disease.The Korean journal of internal medicine · 2020Review
- Dietary vitamin D interacts with high phosphate-induced cardiac remodeling in rats with normal renal function.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2020Article
- Diet and Chronic Kidney Disease.Advances in nutrition (Bethesda, Md.) · 2019Review
- Fractional Excretion of Phosphate (FeP) Is Associated with End-Stage Renal Disease Patients with CKD 3b and 5.Journal of clinical medicine · 2019Article
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Authors and funding
7 authors at 6 institutions in 1 country.
Funding
Abstract
KDIGO guidelines recommend dietary phosphate restriction to lower serum phosphate levels in CKD stages 3-5. Recent studies suggest that dietary phosphate intake is only weakly linked to its serum concentration, and the relationship of phosphate intake with adverse outcomes is uncertain. To evaluate this, we used Cox proportional hazards models to assess associations of baseline 24-h urine phosphate excretion with risk of end-stage renal disease (ESRD), all-cause mortality, and mortality subtypes (cardiovascular disease [CVD] and non-CVD) using the Modification of Diet in Renal Disease data. Models were adjusted for demographics, CVD risk factors, iothalamate GFR, and urine protein and nitrogen excretion. Phosphate excretion was modestly inversely correlated with serum phosphate concentrations. There was no association of 24-h urinary phosphate excretion with risk of ESRD, CVD, non-CVD, or all-cause mortality. For comparison, higher serum phosphate concentrations were associated with all-cause mortality (hazard ratio per 0.7 mg/dl higher, 1.15 [95% CI 1.01, 1.30]). Thus, phosphate intake is not tightly linked with serum phosphate concentrations in CKD stages 3-5, and there was no evidence that greater phosphate intake, assessed by 24-h phosphate excretion, is associated with ESRD, CVD, non-CVD, or all-cause mortality in CKD stages 3-5. Hence, factors other than dietary intake may be key determinants of serum phosphate concentrations and require additional investigation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.