A Study Correlating Serum Phosphorus with Endothelial Cell Dysfunction Markers in CKD 5D

Background: Cardiovascular disease is a leading cause of mortality in end-stage kidney disease patients on MHD. Endothelial dysfunction, characterized by impaired nitric oxide production, increased vasoconstrictors and adhesion molecules, is a major contributor. Elevated serum phosphorus levels in CKD patients exacerbate this dysfunction by promoting oxidative stress, vascular calcification, and inflammation. However, there is limited clinical data correlating serum phosphate with endothelial injury in hemodialysis patients. Methods: Prospective study of 37 hemodialysis patients over 6 months. BP (average of 1 week), S. phosphorus, endothelin-1 and ICAM-1 levels measured before first dialysis of the week at baseline and at follow-up after 6 months. Correlation analyses were performed. Results: Mean serum phosphate decreased from 5.45 ± 1.64 to 4.79 ± 1.50 mg/dL. Endothelin-1 decreased from 2.97 ± 1.47 to 2.52 ± 0.90ng/mL. ICAM-1 decreased from 563.87 ± 157.71 to 547.44 ± 161.76 ng/mL. Significant positive correlation between phosphate and ICAM-1 at baseline (ρ= 0.359, p=0.0291) and follow-up (ρ= 0.382, p= 0.0196) Strong correlation between change in phosphate and change in ICAM-1 (ρ= 0.83, p< 0.001) Moderate correlation between phosphate change and endothelin-1 change (ρ= 0.587, p= 0.001) No correlation between serum phosphate and BP measurements. Conclusion: The study highlights significant association between serum phosphate and markers of endothelial dysfunction - Endothelin-1 ICAM-1. The findings emphasize the potential cardiovascular benefits of maintaining optimal phosphate levels in hemodialysis patients. Managing hyperphosphatemia may help reduce endothelial injury and its cardiovascular consequences.Correlation of serum phosphate with endothelin-1 and ICAM-1 over 6 months