ArticlePloS one2018
Phosphate is a potential biomarker of disease severity and predicts adverse outcomes in acute kidney injury patients undergoing continuous renal replacement therapy.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association between blood phosphorus level and clinical outcomes in critically ill patients: A systematic review and meta-analysis.JPEN. Journal of parenteral and enteral nutrition · 2026Pooled it
- Hyperphosphatemia and Outcomes in Critically Ill Patients: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- Biochemical phenotypes of acute kidney injury and their association with major adverse kidney events.Renal failure · 2026Article
- Article
- Phosphate: An Anion Controlling Metabolic Functions.Nutrients · 2026Review
- The effects of elevated phosphate on the kidney - damaging the gatekeeper.Pflugers Archiv : European journal of physiology · 2026Review
- Interpretable machine learning reveals phosphorus-to-albumin ratio as a novel predictor of mortality and acute kidney injury in critically ill pancreatitis patients: a multi-center retrospective analysis.European journal of medical research · 2026Article
- Relationship between urine output and 28-day mortality in patients with acute kidney injury receiving continuous renal replacement therapy.BMC nephrology · 2026Article
- Non-invasive and user-friendly visual detection of salivary phosphate using enzymatic biosensor test strip for chronic kidney disease screening.Analytical and bioanalytical chemistry · 2026Article
- Bridging the gap between biomarkers and bedside decisions: the prognostic value of the blood urea nitrogen-to-albumin ratio in sepsis-associated AKI.Frontiers in nutrition · 2026Article
- Association between blood urea nitrogen-to-creatinine ratio and 28-day mortality in acute kidney injury patients undergoing continuous renal replacement therapy.Scientific reports · 2025Article
- Mean arterial pressure at the initiation of continuous renal replacement therapy as a prognostic indicator in patients with acute kidney injury.Renal failure · 2025Observational
- Development and validation of a prediction model for 90-day mortality among critically ill patients with AKI undergoing CRRT.Journal of nephrology · 2025Article
- The U-shaped association between initial serum phosphate level and mortality of traumatic brain injury patients.Frontiers in neurology · 2025Article
- Prognostic value of the Geriatric Nutritional Risk Index in sepsis-associated acute kidney injury: a retrospective cohort study.Frontiers in nutrition · 2025Article
- Association of Geriatric Nutritional Risk Index with short-term mortality in patients with severe acute kidney injury: a retrospective cohort study.Renal failure · 2024Observational
- Transfer learning-enabled outcome prediction for guiding CRRT treatment of the pediatric patients with sepsis.BMC medical informatics and decision making · 2024Article
- Using machine learning to predict the risk of short-term and long-term death in acute kidney injury patients after commencing CRRT.BMC nephrology · 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
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hyperphosphatemia is associated with mortality in patients with chronic kidney disease, and is common in critically ill patients with acute kidney injury (AKI); however, its clinical implication in these patients is unknown. We conducted an observational study in 1144 patients (mean age, 63.2 years; male, 705 [61.6%]) with AKI who received continuous renal replacement therapy (CRRT) between January 2009 and September 2016. Phosphate levels were measured before (0 h) and 24 h after CRRT initiation. We assessed disease severity using various clinical parameters. Phosphate at 0 h positively correlated with the Acute Physiology and Chronic Health Evaluation II (APACHE II; P < 0.001) and Sequential Organ Failure Assessment (SOFA; P < 0.001) scores, and inversely with mean arterial pressure (MAP; P = 0.02) and urine output (UO; P = 0.01). In a fully adjusted linear regression analysis for age, sex, Charlson comorbidity index (CCI), MAP, and estimated glomerular filtration rate (eGFR), higher 0 h phosphate level was significantly associated with high APACHE II (P < 0.001) and SOFA (P = 0.04) scores, suggesting that phosphate represents disease severity. A multivariable Cox model also showed that hyperphosphatemia was significantly associated with increased 28-day (HR 1.05, 95% CI 1.02-1.08, P = 0.001) and 90-day (HR 1.05, 95% CI 1.02-1.08, P = 0.001) mortality. Furthermore, patients with increased phosphate level during 24 h were at higher risk of death than those with stable or decreased phosphate levels. Finally, c-statistics significantly increased when phosphate was added to a model that included age, sex, CCI, body mass index, eGFR, MAP, hemoglobin, serum albumin, C-reactive protein, and APACHE II score. This study shows that phosphate is a potential biomarker that can reflect disease severity and predict mortality in critically ill patients receiving CRRT.
Indexed as
Identifiers
What OpenQuestion holds
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.