Table 2 Adjusted hazard ratios (95% confidence interval) of risk of progression to end-stage renal disease (ESRD), acute coronary syndrome (ACS,) and all-cause mortality by Ca-P trajectories.

	N	Cases	Person-years	Incidence	Crude HR (95% CI)	Model 1	Model 2	Model 3
	N	Cases	Person-years	Incidence	Crude HR (95% CI)	Adjusted HR (95% CI)	Adjusted HR (95% CI)	Adjusted HR (95% CI)
ESRD requiring dialysis^†
Normal calcium/mildly high phosphorus trajectory	1810	99	7960.05	12.4	1.00 (Ref)	1.00 (Ref)	1.00 (Ref)	1.00 (Ref)
Mildly low calcium/moderately high phosphorus trajectory	1705	594	5435.19	109.3	8.84 (7.14, 10.94)	9.50 (7.63, 11.82)	5.98 (4.77, 7.50)	5.92 (4.71, 7.44)
Low calcium/high phosphorus trajectory	722	541	1181.87	457.7	36.74 (29.54, 45.69)	39.15 (31.31, 48.95)	15.68 (12.27, 20.04)	15.20 (11.85, 19.50)
P for trend					<0.001	<0.001	<0.001	<0.001
Acute coronary syndrome^†
Normal calcium/mildly high phosphorus trajectory	1810	113	8881.55	12.7	1.00 (Ref)	1.00 (Ref)	1.00 (Ref)	1.00 (Ref)
Mildly low calcium/moderately high phosphorus trajectory	1705	183	7684.90	23.8	2.01 (1.59, 2.55)	2.29 (1.80, 2.93)	1.92 (1.48, 2.48)	1.94 (1.49, 2.52)
Low calcium/high phosphorus trajectory	722	126	3183.48	39.6	3.75 (2.88, 4.88)	4.28 (3.26, 5.63)	3.26 (2.37, 4.49)	3.18 (2.30, 4.39)
P for trend					<0.001	<0.001	<0.001	<0.001
All-cause mortality
Normal calcium/mildly high phosphorus trajectory	1810	425	9150.44	46.4	1.00 (Ref)	1.00 (Ref)	1.00 (Ref)	1.00 (Ref)
Mildly low calcium/moderately high phosphorus trajectory	1705	611	8065.62	75.8	2.08 (1.83, 2.36)	2.25 (1.97, 2.56)	1.88 (1.64, 2.16)	1.88 (1.64, 2.16)
Low calcium/high phosphorus trajectory	722	304	3493.91	87.0	3.38 (2.90, 3.95)	3.54 (3.02, 4.15)	2.53 (2.12, 3.04)	2.46 (2.05, 2.96)
P for trend					<0.001	<0.001	<0.001	<0.001

Incidence = No. of incident dialysis cases/person-years*1000.
^†With competing risk analysis for death.
Model 1: Adjusted for gender, BMI, smoking status, alcohol consumption, education (n = 4210).
Model 2: Adjusted for gender, BMI, smoking status, alcohol consumption, education, diabetes, hypertension, cardiovascular disease, primary etiologies of CKD, and baseline eGFR (n = 4193).
Model 3: Adjusted for gender, BMI, smoking status, alcohol consumption, education, diabetes, hypertension, cardiovascular disease, primary etiologies of CKD, baseline eGFR, and profiles of baseline medication (n = 4112).
Abbreviations: BMI: body mass index, Ca: calcium, Ca × P: calcium-phosphate product, CI: confidence interval, CKD: chronic kidney disease, eGFR: estimated glomerular filtration rate, ESRD: end stage renal disease, HR: hazard ratio, P: phosphorus.
Reference Ca-P trajectory: Normal calcium/ mildly high phosphorus trajectory; Moderately abnormal Ca-P trajectory: Mildly low calcium/ moderately high phosphorus trajectory; Severely abnormal Ca-P trajectory: Low calcium/ high phosphorus trajectory.

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