Phosphate binder use and mortality among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS): evaluation of possible confounding by nutritional status.

ABSTRACT:

Background

Poor nutritional status and both hyper- and hypophosphatemia are associated with increased mortality in maintenance hemodialysis (HD) patients. We assessed associations of phosphate binder prescription with survival and indicators of nutritional status in maintenance HD patients.

Study design

Prospective cohort study (DOPPS [Dialysis Outcomes and Practice Patterns Study]), 1996-2008.

Setting & participants

23,898 maintenance HD patients at 923 facilities in 12 countries.

Predictors

Patient-level phosphate binder prescription and case-mix-adjusted facility percentage of phosphate binder prescription using an instrumental-variable analysis.

Outcome

All-cause mortality.

Results

Overall, 88% of patients were prescribed phosphate binders. Di

SUBMITTER: Lopes AA 

PROVIDER: S-EPMC3901075 | biostudies-literature | 2012 Jul

REPOSITORIES: biostudies-literature