ArticlePloS one2017
Low serum phosphate as an independent predictor of increased infection-related mortality in dialysis patients: A prospective multicenter cohort study.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00931970 (Comprehensive Prospective Study for Mode of Dialysis Therapy and Outcomes in ESRD), which is not on this map. Cited by 18 papers.
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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.
The trial behind it
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.
Comprehensive Prospective Study for Mode of Dialysis Therapy and Outcomes in ESRD
Who cites it
18 citing papers in PubMed, 29 citations in OpenAlex.
- Two-Step Clinical Pathways to Cardiovascular Mortality in Chronic Kidney Disease and Dialysis -- A Narrative Review.Journal of atherosclerosis and thrombosis · 2026Review
- Dynamic hemoglobin trajectories and mortality in hemodialysis patients: a joint modeling study with iron and phosphorus markers.Frontiers in medicine · 2026Article
- The prognostic value of gait speed in hemodialysis patients: A prospective observational study.PloS one · 2026Observational
- Using Machine Learning to Identify Geographic and Socioeconomic Disparities in Dialysis Facility Outcomes Across the United States.Ochsner journal · 2025Article
- The impact of quality of life on the survival of elderly patients with end-stage renal disease: a prospective multicenter cohort study in Korea.Clinical kidney journal · 2024Article
- Phosphate level predicts mortality in acute kidney injury patients undergoing continuous kidney replacement therapy and has a U-shaped association with mortality in patients with high disease severity: a multicenter retrospective study.Kidney research and clinical practice · 2024Article
- Longer serum phosphorus time in range associated with lower mortality risk among peritoneal dialysis patients: a multicenter retrospective cohort study.BMC nephrology · 2024Article
- Article
- Comparison of survival rates between incident hemodialysis patients and peritoneal dialysis patients: a 5-year prospective cohort study with propensity score matching.Clinical and experimental nephrology · 2023Article
- The benefit of planned dialysis to early survival on hemodialysis versus peritoneal dialysis: a nationwide prospective multicenter study in Korea.Scientific reports · 2023Article
- A real-world analysis of the influence of age on maintenance hemodialysis patients: managing serum phosphorus with sucroferric oxyhydroxide as part of routine clinical care.International urology and nephrology · 2023Article
- Reduced phosphorus is associated with older age and hypoalbuminemia. Risk factors for all-cause mortality in peritoneal dialysis patients.Frontiers in nutrition · 2023Article
- Aberrant serum parathyroid hormone, calcium, and phosphorus as risk factors for peritonitis in peritoneal dialysis patients.Scientific reports · 2021Observational
- Relationship between serum phosphate levels and survival in chronic hemodialysis patients: interactions with age, malnutrition and inflammation.Clinical kidney journal · 2021Article
- Low parathyroid hormone level predicts infection-related mortality in incident dialysis patients: a prospective cohort study.The Korean journal of internal medicine · 2020Article
- Development of a risk prediction model for infection-related mortality in patients undergoing peritoneal dialysis.PloS one · 2019Article
- The Association Between the Levels of Serum Phosphate and Mortality Rates in Pre-Dialysis and Dialysis Patients.Indian journal of nephrologyReview
- High prevalence of biochemical disturbances of chronic kidney disease - mineral and bone disorders (CKD-MBD) in a nation-wide peritoneal dialysis cohort: are guideline goals too hard to achieve?Jornal brasileiro de nefrologiaObservational
Corrections and comments
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Authors and funding
17 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe role of mineral metabolism in mortality among dialysis patients has received increased attention, but some aspects remain unclear. The aim of the present study was to investigate the prognostic value of serum calcium and phosphate levels for all-cause mortality and cause-specific mortality in dialysis patients.
methodsPatients on hemodialysis and peritoneal dialysis were enrolled from a multicenter prospective cohort study in Korea (NCT00931970). The patients were divided into low, normal, and high groups according to their baseline serum calcium or phosphate levels. Cox proportional analysis and a proportional hazards model for the subdistribution of a competing risk were used to calculate hazard ratios (HRs) for the association of serum calcium and phosphate levels with all-cause and cause-specific mortality. Time-dependent values of calcium and phosphate were also evaluated to assess the effect of longitudinal change in mineral metabolism parameters on mortality types.
resultsA total of 3,226 dialysis patients were followed up for a mean of 19.8 ± 8.2 months. Infection was the most common cause of death. Low serum phosphate was significantly associated with all-cause and infection-related death using time-dependent values (HR, 1.43 [95% confidence interval (CI), 1.06-1.93], P = 0.02, and HR, 1.66 [95% CI, 1.02-2.70], P = 0.04, respectively). Low serum phosphate was associated with significantly higher infection-related mortality, especially in patients older than 65 years or on dialysis more than one year or with serum albumin lower than 3.9 g/dL (HR, 2.06 [95% CI, 1.13-3.75], P = 0.02, HR, 2.19 [95% CI, 1.20-4.01], P = 0.01, and HR, 1.77 [95% CI, 1.00-3.13], P = 0.05, respectively). Multinomial logistic regression analysis results suggested that low serum albumin, creatinine, and body mass index correlated with low serum phosphate.
conclusionsLow serum phosphate in dialysis patients was an independent risk factor for infection-related death, especially in elderly patients. Persistently low serum phosphate might be a nutritional biomarker to predict increased susceptibility to infection and in turn worse outcomes in dialysis patients.
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