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NDT Advance Access originally published online on October 11, 2006
Nephrology Dialysis Transplantation 2007 22(2):667-668; doi:10.1093/ndt/gfl593
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Serum phosphate and outcomes in PD patients

Email: ansell{at}renalreg.com

Sir,

In relation to the findings by Noordzij et al. [1] on mineral metabolism and mortality risk in peritoneal dialysis (PD) patients when compared with haemodialysis (HD) patients, the UK Renal Registry in 2003 has also published analyses on this subject (www.renalreg.org) [2]. These findings by Noordzij et al. support our analyses showing similar risks for high serum phosphate in both PD and HD patients (Figures 1–3GoGo).


Figure 1
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  		Fig. 1. Serum phosphate and relative hazard of death by dialysis modality.

 

Figure 2
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  		Fig. 2. Serum calcium (unadjusted for albumin) and phosphate product and relative hazard of death by dialysis modality.

 

Figure 3
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  		Fig. 3. Serum calcium [adjusted for albumin measured by bromocresol green (BCG)] and phosphate product and relative hazard of death by dialysis modality.

 
In addition, all our eight annual reports consistently show that in a large cohort of over 11 000 dialysis patients, PD patients achieve better phosphate control than HD patients with a mean phosphate of 1.56 mmol/l, n = 3084 in PD vs 1.65 mmol/l, n = 8,327 in HD). This provides the largest available body of evidence to also support the letter by Noordzij et al. [3] on the differences in serum phosphate in these patients. In addition, we have analysed a subset of patients who changed modality from PD to HD and showed that serum phosphate rose by 0.2 mmol/l in these patients (www.renalreg.org) [4]. This indicates that the difference in phosphate achievement in these two dialysis groups is related to the dialysis modality and is not a ‘patient factor’.

Renal registries are publishing regular analyses on these and many other topics and although not peer reviewed, are often overlooked as a source for routine analyses of data on renal replacement therapy patients.

David Ansell

Director, UK Renal Registry

References

  1. Noordzij M, Korevaar JC, Bos WJ, et al. (2006) Krediet, and for the NECOSAD Study Group Mineral metabolism and cardiovascular morbidity and mortality risk: peritoneal dialysis patients compared with haemodialysis patients. Nephrol Dial Transplant 21:2513–2520.[Abstract/Free Full Text]
  2. Ansell D and Feest T. (2003) UK Renal Registry Report. Chapter 9. www.renalreg.org.
  3. Noordzij M, Korevaar JC, Boeschoten EW, Dekker FW, Bos WJ, Raymond T. (2006) Krediet hyperphosphataemia and related mortality. Nephrol Dial Transplant 21:2676–2677.[Free Full Text]
  4. Ansell D and Feest T. (2004) UK Renal Registry Report. Chapter 9, figure 9.7. www.renalreg.org.

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S. V. Badve, D. L. Zimmerman, G. A. Knoll, K. D. Burns, and B. B. McCormick
Peritoneal Phosphate Clearance is Influenced by Peritoneal Dialysis Modality, Independent of Peritoneal Transport Characteristics
Clin. J. Am. Soc. Nephrol., November 1, 2008; 3(6): 1711 - 1717.
[Abstract] [Full Text] [PDF]

This Article
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