Table 2 Association between treatment with phosphate-binders and infection-related mortality (n = 2926).

From: Use of phosphate-binders and risk of infection-related and all-cause mortality in patients undergoing hemodialysis: The Q-Cohort Study

Models

Unadjusted model

Model 1

Model 2

Model 3

HR (95% CI)

P-value

HR (95% CI)

P-value

HR (95% CI)

P-value

HR (95% CI)

P-value

Use of phosphate-binders

   Cox proportional hazard model

0.31 (0.21–0.46)

<0.001

0.46 (0.30–0.70)

0.004

0.47 (0.31–0.72)

0.007

0.63 (0.40–0.99)

0.049

   Fine-Gray subdistribution hazards model

0.35 (0.23–0.52)

<0.001

0.53 (0.34–0.80)

0.003

0.53 (0.34–0.82)

0.004

0.64 (0.39–1.05)

0.078

Every 1 g/day increase in daily phosphate-binders dose

   Cox proportional hazard model

0.61 (0.52–0.72)

<0.001

0.72 (0.61–0.85)

<0.001

0.72 (0.61–0.85)

<0.001

0.81 (0.68–0.97)

0.023

   Fine-Gray subdistribution hazards model

0.64 (0.54–0.76)

<0.001

0.75 (0.63–0.89)

0.001

0.75 (0.63–0.89)

0.001

0.82 (0.69–0.98)

0.031

  1. The risk estimates are expressed as HR (95%CI). The HR was estimated using Cox proportional hazard model for conventional approach and Fine-Gray subdistribution hazards model for dealing with competing risk. The following covariates were included in each model: Model 1, age, sex, presence of diabetes mellitus and comorbidity, dialysis vintage, dialysis time per session, Kt/V for urea; Model 2, covariates in Model 1, cardiothoracic ratio, systolic blood pressure, blood hemoglobin level, serum levels of corrected calcium, phosphate, alkaline phosphatase, parathyroid hormone, use of erythropoiesis stimulating agents, anti-hypertensives, and vitamin D receptor activators; Model 3, covariates in Model 2, normalized protein catabolic rate, body mass index, serum levels of urea nitrogen, creatinine, albumin, total cholesterol, and C-reactive protein. Total daily dose of phosphate-binders was expressed as that of calcium carbonate. In this study, Phosphate binding capacity of 750 mg of sevelamer dose was regarded equivalent to that of 500 mg of calcium carbonate. A two-tailed P-value less than 0.05 was considered statistically significant. Abbreviations: CI, confidence interval; HR, hazard ratio.
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