Achievement of NKF/K-DOQI recommended target values for bone and mineral metabolism in incident hemodialysis patients: Results of the FARO-2 cohort
| Autor: | Cozzolino, M, Messa, P, Brancaccio, D, Cannella G, Bolasco P, Di Luca, M, Costanzo, Am, Paparatti, U, Festa, V, Gualberti, G, Mazzaferro, S, Bonomini, M, Cancarini, Giovanni, Caruso, Mr, Galfré, A, Gesualdo L, Lodeserto C, Malberti, F, Marangella, M, Morosetti, M, Quarello, F, Rombolà, G, Stefoni, S. |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
Questionnaires medicine.medical_specialty NKF/K-DOQI Survival medicine.medical_treatment Urology Aged Aged 80 and over Biomarkers Bone and Bones Calcium Female Humans Kidney Failure Chronic Middle Aged Parathyroid Hormone Phosphorus Practice Guidelines as Topic Prospective Studies Surveys and Questionnaires Survival Analysis Renal Dialysis Lower risk Kidney Failure 80 and over Medicine Mineral metabolism In patient Chronic Prospective cohort study Survival analysis Cardiovascular mortality Mineral Bone Disorders Settore MED/14 - Nefrologia business.industry Medicine (all) General Medicine Hematology Surgery Nephrology Incident haemodialysis Biological Markers Cohort Hemodialysis business |
| Popis: | Background: Mineral Bone Disorders (MBD) is prevalent in hemodialysis (HD) patients and associated with increased cardiovascular mortality. The FARO-2 study evaluated the achievement of the NKF/K-DOQI guidelines on recommended target values for serum calcium (Ca), phosphorous (P) and intact parathyroid hormone (PTH) levels on survival in incident HD patients. Methods: Data were collected by questionnaire from 568 incident HD patients followed prospectively over a 3-year period from 26 Italian dialysis units. The cumulative probability of time-to-death for CKD-MBD treatment characteristics was determined by the Kaplan-Meier curves. Results: Serum PTH levels (median values at 6 months vs. 36 months; 225 vs. 254 pg/ml), Ca (8.8 vs. 8.9 g/dl) and P (5.1 vs. 4.8 mg/dl) were not significantly different at 6 months versus follow-up. The majority of incident HD patients (60-70%) who were followed up for 36 months did not achieve the NKF/K-DOQI recommended target values. Survival rates were higher in patients on target for three parameters versus patients off target (survival at 24 months: at target 95.7% (95% CI: 84.0-98.9) versus not on target 71.1% (95% CI: 66.3-75.4, p < 0.01)). The 30.1% of patients on target for three MBD parameters at least once during the follow-up period had better survival rates compared to those not reaching these targets (survival at 24 months: at least once 88.0% (95% CI: 81.9-92.1); 67.7% (95% CI: 61.9-72.8, p < 0.01)). Conclusion: Our findings indicate that incident HD patients who achieved target levels (for three MBD parameters) for at least one visit have a lower risk of mortality. |
| Databáze: | OpenAIRE |
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