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Phosphate is a potential biomarker of disease severity and predicts adverse outcomes in acute kidney injury patients undergoing continuous renal replacement therapy

DC FieldValueLanguage
dc.contributor.author강신욱-
dc.contributor.author권재열-
dc.contributor.author기연경-
dc.contributor.author김형래-
dc.contributor.author박서현-
dc.contributor.author박정탁-
dc.contributor.author유태현-
dc.contributor.author윤창연-
dc.contributor.author윤해룡-
dc.contributor.author정수영-
dc.contributor.author지종현-
dc.contributor.author한승혁-
dc.date.accessioned2018-08-28T16:47:08Z-
dc.date.available2018-08-28T16:47:08Z-
dc.date.issued2018-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/161934-
dc.description.abstractHyperphosphatemia 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.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherPublic Library of Science-
dc.relation.isPartOfPLOS ONE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAcute Kidney Injury/metabolism/mortality/*pathology-
dc.subject.MESHAdult-
dc.subject.MESHBiomarkers/*metabolism-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHHyperphosphatemia/metabolism-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPhosphates/blood/*metabolism-
dc.subject.MESHPrognosis-
dc.subject.MESH*Renal Replacement Therapy-
dc.subject.MESHSeverity of Illness Index-
dc.titlePhosphate is a potential biomarker of disease severity and predicts adverse outcomes in acute kidney injury patients undergoing continuous renal replacement therapy-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Internal Medicine-
dc.contributor.googleauthorSu-Young Jung-
dc.contributor.googleauthorJaeyeol Kwon-
dc.contributor.googleauthorSeohyun Park-
dc.contributor.googleauthorJong Hyun Jhee-
dc.contributor.googleauthorHae-Ryong Yun-
dc.contributor.googleauthorHyoungNae Kim-
dc.contributor.googleauthorYoun Kyung Kee-
dc.contributor.googleauthorChang-Yun Yoon-
dc.contributor.googleauthorTae-Ik Chang-
dc.contributor.googleauthorEa Wha Kang-
dc.contributor.googleauthorJung Tak Park-
dc.contributor.googleauthorTae-Hyun Yoo-
dc.contributor.googleauthorShin-Wook Kang-
dc.contributor.googleauthorSeung Hyeok Han-
dc.identifier.doi10.1371/journal.pone.0191290-
dc.contributor.localIdA00053-
dc.contributor.localIdA05451-
dc.contributor.localIdA00276-
dc.contributor.localIdA01147-
dc.contributor.localIdA01495-
dc.contributor.localIdA01654-
dc.contributor.localIdA02526-
dc.contributor.localIdA02613-
dc.contributor.localIdA04617-
dc.contributor.localIdA04667-
dc.contributor.localIdA03970-
dc.contributor.localIdA04304-
dc.relation.journalcodeJ02540-
dc.identifier.eissn1932-6203-
dc.identifier.pmid29415048-
dc.contributor.alternativeNameKang, Shin Wook-
dc.contributor.alternativeNameKwon, Jaeyeol-
dc.contributor.alternativeNameKee, Youn Kyung-
dc.contributor.alternativeNameKim, Hyoung Rae-
dc.contributor.alternativeNamePark, Seo Hyun-
dc.contributor.alternativeNamePark, Jung Tak-
dc.contributor.alternativeNameYoo, Tae Hyun-
dc.contributor.alternativeNameYoon, Chang Yun-
dc.contributor.alternativeNameYun, Hae Ryong-
dc.contributor.alternativeNameJung, Su Young-
dc.contributor.alternativeNameJhee, Jong Hyun-
dc.contributor.alternativeNameHan, Seung Hyeok-
dc.contributor.affiliatedAuthorKang, Shin Wook-
dc.contributor.affiliatedAuthorKwon, Jaeyeol-
dc.contributor.affiliatedAuthorKee, Youn Kyung-
dc.contributor.affiliatedAuthorKim, Hyoung Rae-
dc.contributor.affiliatedAuthorPark, Seo Hyun-
dc.contributor.affiliatedAuthorPark, Jung Tak-
dc.contributor.affiliatedAuthorYoo, Tae Hyun-
dc.contributor.affiliatedAuthorYoon, Chang Yun-
dc.contributor.affiliatedAuthorYun, Hae Ryong-
dc.contributor.affiliatedAuthorJung, Su Young-
dc.contributor.affiliatedAuthorJhee, Jong Hyun-
dc.contributor.affiliatedAuthorHan, Seung Hyeok-
dc.citation.volume13-
dc.citation.number2-
dc.citation.startPagee0191290-
dc.identifier.bibliographicCitationPLOS ONE, Vol.13(2) : e0191290, 2018-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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