Higher serum phosphorus is associated with catabolic/anabolic imbalance in heart failure

Piotr Rozentryt, Jacek T. Niedziela, Bartosz Hudzik, Andrzej Lekston, Wolfram Doehner, Ewa A. Jankowska, Jolanta Nowak, Stephan Von Haehling, Robert Partyka, Tomasz Rywik, Stefan D. Anker, Piotr Ponikowski, Lech Poloński

Research output: Contribution to journalArticlepeer-review


Background A higher serum phosphate level is associated with worse outcome. Energy-demanding intracellular transport of phosphate is needed to secure anion bioavailability. In heart failure (HF), energy starvation may modify intracellular and serum levels of phosphate. We analysed determinants of serum phosphates in HF and assessed if catabolic/anabolic balance (CAB) was associated with elevation of serum phosphate. Methods We retrospectively reviewed data from 1029 stable patients with HF and have calculated negative (loss) and positive (gain) components of weight change from the onset of HF till index date. The algebraic sum of these components was taken as CAB. The univariate and multivariable predictors of serum phosphorus were calculated. In quintiles of CAB, we have estimated odds ratios for serum phosphorus above levels previously identified to increase risk of mortality. As a reference, we have selected a CAB quintile with similar loss and gain. Results Apart from sex, age, and kidney function, we identified serum sodium, N-terminal fragment of pro-brain-type natriuretic peptide, and CAB as independent predictors of serum phosphorus. The odds for serum phosphorus above thresholds found in literature to increase risk were highest in more catabolic patients. In most catabolic quintile relative to neutral balance, the odds across selected phosphorus thresholds rose, gradually peaking at 1.30 mmol/L with a value of 3.29 (95% confidence interval: 2.00–5.40, P

Original languageEnglish
Pages (from-to)325-334
Number of pages10
JournalJournal of Cachexia, Sarcopenia and Muscle
Issue number4
Publication statusPublished - 2015


  • Anabolism
  • Catabolism
  • Chronic
  • Determinants
  • Heart failure
  • Serum phosphorus

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physiology (medical)


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