Serum Phosphorus Levels, Race, and Socioeconomic Status in Incident Hemodialysis Patients

Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation
Victoria A KumarMargo A Sidell

Abstract

We sought to examine the relationship between race, socioeconomic status, and serum phosphorus levels in patients with end-stage renal disease incident to hemodialysis (HD) at a large, integrated health-care delivery system in Southern California. Retrospective cohort study. A total of 5,778 adult patients who initiated HD at our institution between January 1, 2007 and June 30, 2013. Unadjusted and adjusted time-averaged serum phosphorus levels and actual phosphorus levels over time. Phosphorus levels were also analyzed by repeated measures as a continuous measure and by phosphorus category. Baseline patient covariates included age, self-reported race, gender, cause of end-stage renal disease, and Charlson comorbidity index scores. Education and income level were estimated using geocoded data. A total of 68,372 phosphorus levels were available for 4,862 patients. Estimated annual family income fell below $40,001 in 66.1% of African Americans (AAs) and 62.7% of Hispanics compared with 43.5% of Asians and 43.7% of whites, P < .0001. Educational level fell into the highest category for whites (70.8%) compared with AA (44.8%) or Hispanic (30.5%) patients, P < .0001. Adjusted time-averaged phosphorus levels were lower among Hispanic...Continue Reading

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Citations

Sep 30, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Marciana LasterKamyar Kalantar-Zadeh

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