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.
Achievement of NKF/K-DOQI recommended target values for bone and mineral metabolism in incident hemodialysis patients : results of the FARO-2 Cohort / M. Cozzolino, P. Messa, D. Brancaccio, G. Cannella, P. Bolasco, M. Di Luca, A.M. Costanzo, U. di Luzio Paparatti, V. Festa, G. Gualberti, S. Mazzaferro. - In: BLOOD PURIFICATION. - ISSN 0253-5068. - 38:1(2014 Nov), pp. 37-45.
|Titolo:||Achievement of NKF/K-DOQI recommended target values for bone and mineral metabolism in incident hemodialysis patients : results of the FARO-2 Cohort|
|Parole Chiave:||mineral bone disorders; NKF/K-DOQI; incident haemodialysis; survival|
|Settore Scientifico Disciplinare:||Settore MED/14 - Nefrologia|
|Data di pubblicazione:||nov-2014|
|Data ahead of print / Data di stampa:||27-set-2014|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1159/000365386|
|Appare nelle tipologie:||01 - Articolo su periodico|