[ Back to EurekAlert! ] Public release date: 5-Nov-2009
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Contact: Shari Leventhal
sleventhal@asn-online.org
202-416-0658
American Society of Nephrology

Small increases in phosphorus mean higher risk of heart disease

Higher phosphorus and lower kidney function linked to coronary artery calcifications

IMAGE: This is an image of Robert A. Short, Ph.D., a co-author of the study.

Click here for more information.

Higher levels of phosphorus in the blood are linked to increased calcification of the coronary arteries— a key marker of heart disease risk, according to a study in an upcoming issue of Clinical Journal of the American Society of Nephrology (CJASN). "This may help to explain why even early-stage chronic kidney disease (CKD) is associated with increased cardiovascular risk that is not otherwise explained by traditional risk factors," comments Katherine R. Tuttle, MD (Providence Medical Research Center, Spokane, WA).

The study looked at the relationship between phosphorus levels and coronary artery calcification (CAC) in nearly 900 healthy adults from the Spokane Heart Study, a long-term study of heart disease risk factors. Previous studies have linked CAC—an early sign of atherosclerosis ("hardening of the arteries")—to an increased risk of myocardial infarction (heart attack) and other cardiovascular events. At the start of the study, 28 percent of the participants had CAC.

After six years' follow-up, another 33 percent of participants had developed CAC. For those who already had CAC, the level of CAC increased during follow-up.

The relationship between phosphorus levels and CAC remained significant even after adjustment for other factors. "Even small increases in the blood level of phosphorus predicted an increased risk of progressive CAC in these apparently healthy adults," says Tuttle. The phosphorus-related increase in CAC was comparable to that seen with traditional heart disease risk factors like high blood pressure and high cholesterol.

In addition, participants with lower levels of kidney function—even if not below the normal range—were more likely to have progressive CAC. Recent studies have linked higher phosphorus levels to increased CAC in patients with CKD as well.

IMAGE: This is an image of study author Katherine R. Tuttle, M.D..

Click here for more information.

"Our results may help explain why even early-stage CKD is associated with increased cardiovascular risk that is not explained by traditional risk factors," says Tuttle. More research will be needed to see if treatments to lower phosphorus levels can reduce heart disease risk in people with early-stage CKD, or even those without CKD who have CAC."

The study had some important limitations, including the use of estimated kidney function levels. In addition, it did not address several factors that can affect phosphorus levels, such as parathyroid hormone and vitamin D.

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Robert A. Short, PhD (also of Providence Medical Research Center) was co-author of the study. The authors reported no financial disclosures.

The study, "Longitudinal Relationships among Coronary Artery Calcification, Serum Phosphorus, and Kidney Function," will appear in an upcoming issue of CJASN and online at http://cjasn.asnjournals.org/ on November 5, doi 10.2215/CJN.01250209.

The American Society of Nephrology (ASN) does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, ASN is the world's largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.



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