Table 1.
Patient characteristics by phosphate binder prescription (n=23,898)
| Characteristics | Phosphate Binder |
Minimally Adjusted Odds Ratioa (95% CI)* |
Extensively Adjusted Odds Ratio (95% CI)† |
|
|---|---|---|---|---|
| Yes | No | |||
| N (%) | 21,061 (88.1%) | 2,837 (11.9%) | ||
| Age in years (mean±SD, per 10 years older) | 61.4±14.6 | 65.6±14.1 | 0.76 (0.71, 0.82) | 0.78 (0.73, 0.84) |
| Black (%, vs. non-black) | 12.3 | 11.6 | 0.78 (0.64, 0.96) | 0.76 (0.62, 0.93) |
| Black restricted to US (%) | 37.7 | 37.3 | ||
| Hispanic restricted to US (%) | 9.7 | 9.6 | ||
| Male (%, vs. female) | 57.3 | 56.5 | 1.01 (0.93, 1.10) | 1.02 (0.93, 1.11) |
| Presence of residual kidney function (%, vs. absence) | 26.2 | 29.4 | 0.83 (0.75, 0.93) | 0.86 (0.77, 0.96) |
| Years of ESRD (median, per 1 year longer) | 3.4 | 2.6 | 1.02 (1.01, 1.03) | 1.02 (1.01, 1.03) |
| Comorbidities (%, vs. absence) | ||||
| Coronary Artery Disease | 45.7 | 47.7 | 0.94 (0.85, 1.04) | 0.96 (0.87, 1.06) |
| Cancer | 10.8 | 12.2 | 0.99 (0.87, 1.14) | 1.00 (0.87, 1.14) |
| Other Cardiovascular Disease | 36.1 | 39.4 | 0.93 (0.85, 1.03) | 0.93 (0.84, 1.03) |
| Cerebrovascular Disease | 16.7 | 20.5 | 0.84 (0.76, 0.94) | 0.93 (0.82, 1.04) |
| Congestive Heart Failure | 32.9 | 33.3 | 0.96 (0.85, 1.07) | 1.02 (0.90, 1.15) |
| Diabetes | 34.9 | 37.7 | 0.86 (0.78, 0.95) | 0.91 (0.82, 1.01) |
| Gastrointestinal Bleed | 5.8 | 7.4 | 0.80 (0.67, 0.94) | 0.84 (0.71, 0.99) |
| Hypertension | 78.3 | 73.1 | 1.22 (1.09, 1.36) | 1.31 (1.17, 1.47) |
| Lung Disease | 10.9 | 11.4 | 0.95 (0.83, 1.10) | 0.98 (0.85, 1.12) |
| Neurologic Disorder | 10.2 | 14.7 | 0.64 (0.56, 0.73) | 0.67 (0.58, 0.78) |
| Psychological Disorder | 16.4 | 17.7 | 0.79 (0.69, 0.89) | 0.84 (0.74, 0.96) |
| Peripheral Vascular Disease | 25.6 | 27.3 | 0.91 (0.83, 1.01) | 0.96 (0.85, 1.09) |
| Cellulitis, Skin Infection or Gangrene | 8.2 | 8.4 | 0.87 (0.75, 1.01) | 0.96 (0.81, 1.14) |
| Alcohol Abuse | 2.9 | 3.9 | 0.60 (0.45, 0.81) | 0.72 (0.52, 1.01) |
| Dementia | 3.2 | 6.3 | 0.58 (0.47, 0.71) | 0.82 (0.64, 1.05) |
| Ascites within the past 12 months | 1.3 | 1.9 | 0.67 (0.46, 0.97) | 0.75 (0.51, 1.09) |
| Hepatitis B or C | 12 | 12 | 0.98 (0.86, 1.13) | 0.92 (0.80, 1.06) |
| Vascular Access by Catheter (%, vs. other VA) | 13.7 | 15 | 0.83 (0.72, 0.96) | 0.89 (0.77, 1.03) |
| Hospitalization in the last 3 months (%, vs. none) | 19 | 26.8 | 0.69 (0.62, 0.78) | 0.74 (0.66, 0.84) |
| Prescription of Vitamin D and analogs (%, vs. none) | 49.3 | 39.7 | 1.45 (1.29, 1.64) | 1.44 (1.27, 1.62) |
| Hemoglobin in g/dL (mean±SD, per 1 g/dL higher) | 11.2±1.6 | 10.9±1.7 | 1.07 (1.04, 1.12) | 1.06 (1.03, 1.10) |
| Hemoglobin<9 g/dL (%, vs. ≥9) | 8.1 | 12.8 | 0.73 (0.63, 0.86) | 0.75 (0.64, 0.88) |
| SpKt/V (mean±SD, per 0.1 higher) | 1.44±0.29 | 1.41±0.33 | 1.02 (0.99, 1.04) | 1.01 (0.98, 1.03) |
| Serum phosphate in mg/dL (mean±SD, per 1 mg/dL higher) | 5.6±1.8 | 5.2±1.8 | 1.17 (1.12, 1.21) | 1.16 (1.11, 1.21) |
| Serum phosphate < 3.0 mg/dL (%, vs. ≥3) | 4 | 7.2 | 0.59 (0.49, 0.71) | 0.60 (0.49, 0.72) |
| Serum phosphate > 7.0 mg/dL (%, vs. ≤7) | 18.1 | 13.5 | 1.39 (1.20, 1.60) | 1.37 (1.19, 1.58) |
| Serum Calciumalb in mg/dL (mean±SD, per 1 mg/dL higher) | 9.5±0.89 | 9.4±0.97 | 1.12 (1.05, 1.19) | 1.10 (1.03, 1.16) |
| PTH in pg/mL (median, per 100 pg/mL higher) | 165 | 157.5 | 0.99 (0.98, 1.01) | 0.99 (0.98, 1.01) |
| Cachectic Appearance (%, vs. none) | 8 | 13.7 | 0.54 (0.47, 0.63) | 0.57 (0.50, 0.66) |
| Body Mass Index in kg/m2 (mean±SD, per 1 kg/m2 higher) | 24.4±5.6 | 23.41±5.1 | 1.04 (1.02, 1.05) | 1.04 (1.03, 1.06) |
| Body Mass Index <18.5 kg/m2 (%, vs. ≥18.5 kg/m2) | 10 | 15.2 | 0.65 (0.56, 0.74) | 0.63 (0.55, 0.73) |
| Serum Albumin in g/dL (mean±SD) | 3.8±0.5 | 3.7±0.5 | 1.59 (1.41, 1.80) | 1.52 (1.35, 1.72) |
| Serum Albumin <3 g/dL (%, vs. ≥3 g/dL) | 3.9 | 7.7 | 0.49 (0.41, 0.59) | 0.53 (0.44, 0.63) |
| Serum Creatinine in mg/dL (mean±SD, per 1 mg/dL higher) | 9.6±3.0 | 8.2±3.0 | 1.25 (1.21, 1.30) | 1.27 (1.23, 1.32) |
| Serum Creatinine <8 mg/dL (%, vs. ≥8 mg/dL) | 30.5 | 51.9 | 0.38 (0.34, 0.43) | 0.38 (0.34, 0.42) |
| nPCR in g/kg/day (mean±SD, per 0.1 g/kg/day higher) | 1.04±0.2 | 0.96±0.3 | 1.14 (1.12, 1.17) | 1.13 (1.11, 1.16) |
| nPCR <1 g/kg/day (%, vs. ≥1 g/kg/day) | 46.1 | 59.9 | 0.60 (0.54, 0.66) | 0.62 (0.56, 0.69) |
US to International Conversions: serum albumin in g/dL to g/L, x10; serum calcium in mg/dL to mmol/L, x0.2495; serum creatinine in mg/dL to µmol/L, x88.4; hemoglobin in g/dL to g/L, x10; PTH in pg/mL to ng/L, no conversion needed; serum phosphorus in mg/dL to mmol/L, x0.3229.
Odds ratios indicate likelihood of PB prescription for the given unit increase (continuous variables) or compared to the referent group (dichotomous variables).
The logistic models for the minimally adjusted odds ratios include geographic region, study phase, and age and accounting for facility clustering effects.
The logistic models for the extensively adjusted odds ratios include geographic region, study phase, age, race, male, residual kidney function (yes/no), years with ESRD, and 13 summary comorbid conditions (coronary heart disease, cancer, other cardiovascular disease, cerebrovascular disease, congestive heart disease, diabetes mellitus, GI bleeding, hypertension, lung disease, neurological disorders, psychological disorders, peripheral vascular disease, and recurrent cellulitis/gangrene), and accounting for facility clustering effects.
Calciumalb = albumin-corrected calcium; ESRD = End-stage renal disease; nPCR = normalized protein catabolic rate; PTH = parathyroid hormone; SpKt/V = single pool Kt/V.