The American Journal of Medicine
Volume 122, Issue 4 , Pages 380-386 , April 2009

Serum Phosphorus and Cardiovascular Mortality in Type 2 Diabetes

  • Michel Chonchol, MD

      Affiliations

    • Division of Renal Diseases and Hypertension, University of Colorado at Denver, Health Sciences Center, Denver, Colo
    • Corresponding Author InformationRequests for reprints should be addressed to Michel Chonchol, MD, Division of Renal Diseases and Hypertension, University of Colorado at Denver, Health Sciences Center, Box C-281, Denver, CO 80262
    • ,
  • Rita Dale, MS

      Affiliations

    • Colorado Prevention Center, Denver, Colo
    • ,
  • Robert W. Schrier, MD

      Affiliations

    • Division of Renal Diseases and Hypertension, University of Colorado at Denver, Health Sciences Center, Denver, Colo
    • ,
  • Raymond Estacio, MD

      Affiliations

    • University of Colorado at Denver, Health Sciences Center, Denver, Colo
    • Department of Internal Medicine, Denver Health, Denver, Colo

References 

  1. Levi M, Popovtzer M. Disorders of phosphate balance. In:  Schrier RW,  Berl T,  Bonventre JV editor. Atlas of Diseases of the Kidney. Philadelphia, PA: Current Medicine; 2001;p. 7.1–7.14
  2. Hruska KA, Slatopolsky E. Disorders of phosphorus, calcium, and magnesium metabolism. In:  Schrier RW,  Gottschalk CW editor. Diseases of the Kidney. New York, NY: Little, Brown and Company; 1997;p. 2477–2526
  3. Bellasi A, Kooienga L, Block GA. Phosphate binders: new products and challenges. Hemodial Int. 2006;10:225–234
  4. Block GA. Control of serum phosphorus: implications for coronary artery calcification and calcific uremic arteriolopathy (calciphylaxis). Curr Opin Nephrol Hypertens. 2001;10:741–747
  5. Tonelli M, Sacks F, Pfeffer M, et al. Cholesterol and Recurrent Events Trial Investigators (Relation between serum phosphate level and cardiovascular event rate in people with coronary disease). Circulation. 2005;1120:2627–2633
  6. Dhingra R, Sullivan LM, Fox CS, et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch Intern Med. 2007;167:879–885
  7. Kestenbaum B, Sampson JN, Rudser KD, et al. Serum phosphate levels and mortality risk among people with chronic kidney disease. J Am Soc Nephrol. 2005;16:520–528
  8. Block GA, Hulbert-Shearon TE, Levin NW, Port FK. Association of serum phosphorus and calcium x phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am J Kidney Dis. 1998;31:607–617
  9. Block GA, Klassen PS, Lazarus JM, et al. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004;15:2208–2218
  10. Slinin Y, Foley RN, Collins AJ. Calcium, phosphorus, parathyroid hormone, and cardiovascular disease in hemodialysis patients: the USRDS waves 1, 3, and 4 study. J Am Soc Nephrol. 2005;16:1788–1793
  11. Savage S, Johnson Nagel N, Estacio RO, et al. The ABCD (Appropriate Blood Pressure Control in Diabetes) trial: rationale and design of a trial of hypertension control (moderate or intensive) in type II diabetes. Control Clin Trials. 1996;17:242–257
  12. National Kidney Foundation. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(Suppl 1):S1–S266
  13. Panzram G. Mortality and survival in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1987;30:123–131
  14. Estacio RO, Jeffers BW, Hiatt WR, et al. The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med. 1998;338:645–652
  15. Gregg EW, Cheng YJ, Cadwell BL, et al. Secular trends in cardiovascular disease risk factors according to body mass index in US adults. JAMA. 2005;293:1868–1874
  16. Curb JD, Pressel SL, Cutler JA, et al. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. JAMA. 1996;276:1886–1892
  17. Pyorala K, Pedersen TR, Kjekshus J, et al. Cholesterol lowering with simvastatin improves prognosis of diabetic patients with coronary heart disease: a subgroup analysis of the Scandinavian Simvastatin Survival Study (4S). Diabetes Care. 1997;20:614–620
  18. Goldberg RB, Mellies MJ, Sacks FM, et al. Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels: subgroup analyses in the Cholesterol And Recurrent Events (CARE) trial. Circulation. 1998;98:2513–2519
  19. Franklin K, Goldberg RJ, Spencer F, et al. Implications of diabetes in patients with acute coronary syndromes: the Global Registry of Acute Coronary Events. Arch Intern Med. 2004;164:1457–1463
  20. Malmberg K, Yusuf S, Gerstein HC, et al. Impact of diabetes on long-term prognosis in patients with unstable angina and non-Q-wave myocardial infarction: results of the OASIS (Organization to Assess Strategies for Ischemic Syndromes) Registry. Circulation. 2000;102:1014–1019
  21. Mak KH, Moliterno DJ, Granger CB, et al. Influence of diabetes mellitus on clinical outcome in the thrombolytic era of acute myocardial infarction: GUSTO-I Investigators: Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries. J Am Coll Cardiol. 1997;30:171–179
  22. Doherty TM, Fitzpatrick LA, Inoue D, et al. Molecular, endocrine and genetic mechanisms of arterial calcification. Endocr Rev. 2004;25:629–672
  23. Young MJ, Adams JE, Anderson GF, et al. Medial arterial calcification in the feet of diabetic patients and matched non-diabetic control subjects. Diabetologia. 1993;36:615–621
  24. Lehto S, Niskanen L, Suhonen M, et al. Medial artery calcification (A neglected harbinger of cardiovascular complications in non-insulin-dependent diabetes mellitus). Arterioscler Thromb Vasc Biol. 1996;16:978–983
  25. Block GA, Raggi P, Bellasi A, et al. Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients. Kidney Int. 2007;71:438–441
  26. Hallan S, Astor B, Romundstad S, et al. Association of kidney function and albuminuria with cardiovascular mortality in older vs younger individuals: the HUNT II Study. Arch Intern Med. 2007;167:2490–2496

 Funding: Clinical revenues.

 Conflict of Interest: None.

 Authorship: All authors participated in the conception and design of the study, the interpretation of data, drafting and critical revision of the manuscript, and have read and approved the manuscript.

PII: S0002-9343(08)01060-7

doi: 10.1016/j.amjmed.2008.09.039

The American Journal of Medicine
Volume 122, Issue 4 , Pages 380-386 , April 2009

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