Abstract：
UNASSIGNED: This study investigated the association between serum phosphate level and mortality in acute kidney injury (AKI) patients undergoing continuous kidney replacement therapy (CKRT) and evaluated whether this association differed according to disease severity.
UNASSIGNED: Data from eight tertiary hospitals in Korea were retrospectively analyzed. The patients were classified into four groups (low, normal, high, and very high) based on their serum phosphate level at baseline. The association between serum phosphate level and mortality was then analyzed, with further subgroup analysis being conducted according to disease severity.
UNASSIGNED: Among the 3,290 patients identified, 166, 955, 1,307, and 862 were in the low, normal, high, and very high phosphate groups, respectively. The 90-day mortality rate was 63.9% and was highest in the very high group (76.3%). Both the high and very high groups showed a significantly higher 90-day mortality rate than did the normal phosphate group (high: hazard ratio [HR], 1.35, 95% confidence interval [CI], 1.21-1.51, p < 0.001; very high: HR, 2.01, 95% CI, 1.78-2.27, p < 0.001). The low group also exhibited a higher 90-day mortality rate than did the normal group among those with high disease severity (HR, 1.47; 95% CI, 1.09-1.99; p = 0.01) but not among those with low disease severity.
UNASSIGNED: High serum phosphate level predicted increased mortality in AKI patients undergoing CKRT, and low phosphate level was associated with increased mortality in patients with high disease severity. Therefore, serum phosphate levels should be carefully considered in critically ill patients with AKI.
UNASSIGNED: Data from eight tertiary hospitals in Korea were retrospectively analyzed. The patients were classified into four groups (low, normal, high, and very high) based on their serum phosphate level at baseline. The association between serum phosphate level and mortality was then analyzed, with further subgroup analysis being conducted according to disease severity.
UNASSIGNED: Among the 3,290 patients identified, 166, 955, 1,307, and 862 were in the low, normal, high, and very high phosphate groups, respectively. The 90-day mortality rate was 63.9% and was highest in the very high group (76.3%). Both the high and very high groups showed a significantly higher 90-day mortality rate than did the normal phosphate group (high: hazard ratio [HR], 1.35, 95% confidence interval [CI], 1.21-1.51, p < 0.001; very high: HR, 2.01, 95% CI, 1.78-2.27, p < 0.001). The low group also exhibited a higher 90-day mortality rate than did the normal group among those with high disease severity (HR, 1.47; 95% CI, 1.09-1.99; p = 0.01) but not among those with low disease severity.
UNASSIGNED: High serum phosphate level predicted increased mortality in AKI patients undergoing CKRT, and low phosphate level was associated with increased mortality in patients with high disease severity. Therefore, serum phosphate levels should be carefully considered in critically ill patients with AKI.
摘要：
这项研究调查了接受连续肾脏替代治疗（CKRT）的急性肾损伤（AKI）患者的血清磷酸盐水平与死亡率之间的关系，并评估了这种关系是否根据疾病的严重程度而有所不同。
■对韩国8家三级医院的数据进行了回顾性分析。将患者分为四组(低，正常,高,并且非常高）基于基线时的血清磷酸盐水平。然后分析血清磷酸盐水平与死亡率之间的关系，根据疾病严重程度进行进一步的亚组分析。
■在确定的3,290名患者中，166、955、1,307和862处于低位，正常,高,和非常高的磷酸基团，分别。90天死亡率为63.9％，在极高组中最高（76.3％）。高组和极高组的90天死亡率均明显高于正常磷酸盐组（高：危险比[HR]，1.35，95%置信区间[CI]，1.21-1.51，p<0.001；非常高：HR，2.01，95%CI，1.78-2.27，p<0.001)。在疾病严重程度高的人群中，低组的90天死亡率也高于正常组（HR，1.47；95%CI，1.09-1.99；p=0.01），但在疾病严重程度低的人群中没有。
■高血清磷酸盐水平预测接受CKRT的AKI患者死亡率增加，在疾病严重程度高的患者中,低磷酸盐水平与死亡率增加相关.因此,AKI危重患者应仔细考虑血清磷酸盐水平.
■对韩国8家三级医院的数据进行了回顾性分析。将患者分为四组(低，正常,高,并且非常高）基于基线时的血清磷酸盐水平。然后分析血清磷酸盐水平与死亡率之间的关系，根据疾病严重程度进行进一步的亚组分析。
■在确定的3,290名患者中，166、955、1,307和862处于低位，正常,高,和非常高的磷酸基团，分别。90天死亡率为63.9％，在极高组中最高（76.3％）。高组和极高组的90天死亡率均明显高于正常磷酸盐组（高：危险比[HR]，1.35，95%置信区间[CI]，1.21-1.51，p<0.001；非常高：HR，2.01，95%CI，1.78-2.27，p<0.001)。在疾病严重程度高的人群中，低组的90天死亡率也高于正常组（HR，1.47；95%CI，1.09-1.99；p=0.01），但在疾病严重程度低的人群中没有。
■高血清磷酸盐水平预测接受CKRT的AKI患者死亡率增加，在疾病严重程度高的患者中,低磷酸盐水平与死亡率增加相关.因此,AKI危重患者应仔细考虑血清磷酸盐水平.
