Serum phosphate is associated with left ventricular mass in patients with chronic kidney disease: a cardiac magnetic resonance study

Heart. 2012 Feb;98(3):219-24. doi: 10.1136/heartjnl-2011-300570. Epub 2011 Oct 22.

Abstract

Objective: To explore the relationship between serum phosphate, arterial stiffness and left ventricular mass (LVM) in patients with early-stage chronic kidney disease (CKD).

Design: A cross-sectional observational study.

Setting: Single centre.

Patients: 208 patients with stage 2 to stage 4 non-diabetic CKD.

Interventions: Arterial stiffness was determined through measurement of aortic pulse wave velocity (PWV). Cardiac magnetic resonance was used to determine LVM.

Main outcome measure: Relationship between serum phosphate, aortic PWV and LVM.

Results: Mean age was 54 ± 13 years, mean glomerular filtration rate was 50 ± 15 ml/min/1.73 m(2), mean serum phosphate was 1.11 ± 0.21 mmol/l and mean PWV was 8.6 ± 2.1 m/s. When the cohort was divided into quartiles according to serum phosphate, LVM increased across quartiles (p=0.04), with no significant differences in age, kidney function, blood pressure or PWV. Serum phosphate correlated with LVM (r=0.173; p=0.01), but PWV did not (p=0.2). In a regression model containing gender, serum phosphate, office systolic blood pressure, albumin/creatinine ratio and haemoglobin, 30% of the variation in LVM was explained (p<0.0005), with serum phosphate accounting for 5% of the variance.

Conclusion: Serum phosphate is independently associated with LVM in patients with CKD. Interventional studies are required to determine whether this association is causative and whether reducing phosphate exposure reduces LVM in this population.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Heart Ventricles / pathology*
  • Heart Ventricles / physiopathology
  • Humans
  • Hypertrophy, Left Ventricular / blood
  • Hypertrophy, Left Ventricular / diagnosis*
  • Hypertrophy, Left Ventricular / etiology
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / physiopathology
  • Magnetic Resonance Imaging, Cine / methods*
  • Male
  • Middle Aged
  • Phosphates / blood*
  • Prognosis
  • Reproducibility of Results
  • Severity of Illness Index
  • Ventricular Function, Left / physiology*

Substances

  • Biomarkers
  • Phosphates