HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: CJN.04100808v1 4/3/609    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ix, J. H. Articles by Kestenbaum, B. R. Search for Related Content PubMed PubMed Citation Articles by Ix, J. H. Articles by Kestenbaum, B. R.

Serum Phosphorus Concentrations and Arterial Stiffness among Individuals with Normal Kidney Function to Moderate Kidney Disease in MESA

Joachim H. Ix^*, Ian H. De Boer, Carmen A. Peralta, Kathryn L. Adeney, Daniel A. Duprez^||, Nancy S. Jenny^¶, David S. Siscovick^**, and Bryan R. Kestenbaum

^* Division of Nephrology, Department of Medicine, and Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California San Diego, and Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California; Division of Nephrology, Department of Medicine, Department of Epidemiology, and ^** Cardiovascular Health Research Unit, University of Washington, Seattle, Washington; Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California; ^|| Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; and ^¶ Department of Pathology, College of Medicine, University of Vermont, Burlington, Vermont

Correspondence: Dr. Joachim H. Ix, Division of Nephrology and Hypertension, Department of Medicine, University of California San Diego, and San Diego VA Healthcare System, 3350 La Jolla Village Drive, Mail code 111-H, San Diego, CA 92161. Phone: 858-552-8585, ext. 1657; Fax: 858-552-7549; E-mail: joeix{at}ucsd.edu

Background and objectives: Higher phosphorus levels are associated with cardiovascular disease (CVD) events and mortality. Whether vascular stiffness may be responsible is unknown.

Design, setting, participants, & measurements: This study examined the cross-sectional associations of serum phosphorus with ankle brachial index (ABI), pulse pressure, and large and small artery elasticity by radial artery waveform analysis among 1370 individuals (440 with moderate chronic kidney disease) who did not have clinical CVD and participated in the Multi-Ethnic Study of Atherosclerosis.

Results: Fifty-nine (4%) individuals had high ABI (>1.30), a marker of peripheral arterial stiffness. Participants with phosphorus levels >4 mg/dl had greater than four-fold risk for high ABI compared with participants with phosphate levels <3 mg/dl (relative risk 4.6; 95% confidence interval 1.6 to 13.2; P = 0.01) after adjustment for demographics, traditional CVD risk factors, and kidney function. Higher phosphorus levels were also associated with greater pulse pressure and lesser large and small artery elasticity in unadjusted models, but these associations were attenuated after adjustment.

Conclusions: Higher phosphorus levels are strongly associated with high ABI but not pulse pressure or large or small artery elasticity. If confirmed in future studies, then the association of higher phosphorus concentrations with CVD events may be partially mediated through peripheral arterial stiffness.

This article has been cited by other articles:

				L. C. Plantinga, N. E. Fink, J. Coresh, S. M. Sozio, R. S. Parekh, M. L. Melamed, N. R. Powe, and B. G. Jaar Peripheral Vascular Disease-Related Procedures in Dialysis Patients: Predictors and Prognosis Clin. J. Am. Soc. Nephrol., October 1, 2009; 4(10): 1637 - 1645. [Abstract] [Full Text] [PDF]

				R. N. Foley Phosphate Levels and Cardiovascular Disease in the General Population Clin. J. Am. Soc. Nephrol., June 1, 2009; 4(6): 1136 - 1139. [Abstract] [Full Text] [PDF]