만성신부전 환자의 혈관 석회화와 사망률에 미치는 인결합제의 영향
Effect of Phosphate Binders on Vascular Calcification and Mortality in Korean Patients with Chronic Kidney Disease
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Objectives: Current studies are debating on the association of vascular calcification and the benefit of treatment tolower serum phosphorus level in patients with chronic kidney disease. The aim of this study was to evaluate the associationof mortality and risk of vascular calcification in patients with CKD who were taking phosphate binders. Methods:This study was conducted through retrospective medical chart review for 420 patients aged 18 years and olderwho were admitted for chronic kidney disease. Results: Vascular calcification was not statistically significantly associatedwith increased mortality in patients with CKD [16.7% vs. 19.2%; 95% CI; 0.388 to 1.818 (p=0.656)]. Interventionof calcium-based phosphate binders was not significantly associated with vascular calcification in patients with CKD[9.1% vs. 12.5%; 95% CI; 0.364 to 1.358 (p=0.292)]. Ca x P product ≥ 55 mg2/dL2 was not significantly associated withincreased 1 year mortality in patients with CKD [25.4% vs. 17.5%; 95% CI; 0.851 to 3.013 (p=0.142)]. Intervention ofsevelamer was significantly associated with reduced 1 year mortality in patients with CKD than that of patients whodid not take sevelamer [6.3% vs. 25.3%; 95% CI; 0.044 to 0.880 (p=0.020)]. Conclusion: There was not a statisticallysignificant association between vascular calcification and phosphate binder’s use. But phosphate binder use was significantlyassociated with decreased mortality in patients with CKD.
Abstract
Objectives: Current studies are debating on the association of vascular calcification and the benefit of treatment tolower serum phosphorus level in patients with chronic kidney disease. The aim of this study was to evaluate the associationof mortality and risk of vascular calcification in patients with CKD who were taking phosphate binders. Methods:This study was conducted through retrospective medical chart review for 420 patients aged 18 years and olderwho were admitted for chronic kidney disease. Results: Vascular calcification was not statistically significantly associatedwith increased mortality in patients with CKD [16.7% vs. 19.2%; 95% CI; 0.388 to 1.818 (p=0.656)]. Interventionof calcium-based phosphate binders was not significantly associated with vascular calcification in patients with CKD[9.1% vs. 12.5%; 95% CI; 0.364 to 1.358 (p=0.292)]. Ca x P product ≥ 55 mg2/dL2 was not significantly associated withincreased 1 year mortality in patients with CKD [25.4% vs. 17.5%; 95% CI; 0.851 to 3.013 (p=0.142)]. Intervention ofsevelamer was significantly associated with reduced 1 year mortality in patients with CKD than that of patients whodid not take sevelamer [6.3% vs. 25.3%; 95% CI; 0.044 to 0.880 (p=0.020)]. Conclusion: There was not a statisticallysignificant association between vascular calcification and phosphate binder’s use. But phosphate binder use was significantlyassociated with decreased mortality in patients with CKD.
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