scholarly journals The DOPPS Practice Monitor for US Dialysis Care: Potential Impact of Recent Guidelines and Regulatory Changes on Management of Mineral and Bone Disorder Among US Hemodialysis Patients

2014 ◽  
Vol 63 (5) ◽  
pp. 851-854 ◽  
Author(s):  
Francesca Tentori ◽  
Douglas S. Fuller ◽  
Friedrich K. Port ◽  
Brian A. Bieber ◽  
Bruce M. Robinson ◽  
...  
Keyword(s):  
Hemodialysis Patients ◽  
Mineral And Bone Disorder ◽  
Regulatory Changes ◽  
Bone Disorder ◽  
Potential Impact

MO792CONTEMPORARY MINERAL AND BONE DISORDER MARKERS AND TREATMENT AMONG HEMODIALYSIS PATIENTS IN THE EUROPEAN DIALYSIS OUTCOMES AND PRACTICE PATTERNS STUDY (DOPPS)*

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Brian Bieber ◽  
Indranil Dasgupta ◽  
Pieter Evenepoel ◽  
Stefan H Jacobson ◽  
Piergiorgio Messa ◽  
...  
Keyword(s):  
Vitamin D ◽  
Practice Patterns ◽  
Hemodialysis Patients ◽  
Serum Phosphorus ◽  
Active Vitamin ◽  
Mineral And Bone Disorder ◽  
Bone Disorder ◽  
Country Differences ◽  
Dialysis Outcomes ◽  
The Uk

Abstract Background and Aims Chronic kidney disease mineral and bone disorder (CKD-MBD) is characterized by abnormalities in serum calcium, phosphorus, and parathyroid hormone (PTH) and associated with morbidity and mortality. Previous publications from the Dialysis Outcomes and Practice Patterns Study (DOPPS) have demonstrated country differences in the prevalence and treatment of CKD-MBD among hemodialysis patients in participating European countries. We aim to compare the distribution of CKD-MBD related labs and treatments across countries in a contemporary population of European hemodialysis patients. Method DOPPS is an international prospective cohort study of hemodialysis patients ≥18 years of age. Patients are enrolled randomly from a representative sample of dialysis facilities within each nation at the start of each study phase. The current analysis includes n=1,701 patients from 91 facilities in the initial prevalent cross section of Europe DOPPS phase 7 (2019-present; Belgium, Germany, Italy, Spain, Sweden, UK). Results from Belgium should be considered preliminary as initial questionnaire completion is ongoing. Results The % of patients with a high PTH (>600 pg/mL) ranged from 6% in Italy to 24% in the UK, with 12-17% having high PTH in all other countries. Mean serum total calcium ranged from 8.7 in Germany to 9.1 mg/dL in the UK (Table). Mean serum phosphorus varied from 4.5 in Belgium to 5.3 mg/dL in Germany. Dialysate calcium of 2.5 mEq/L was predominant in Germany, Sweden, and the UK while 3.0 mEq/L was the most common prescription in Belgium, Italy, and Spain. Calcimimetic prescription ranged from 13% in the UK to 32% in Spain. Etelcalcetide prescription ranged from 1% in the UK to 12% in Spain and 14% in Italy. Active vitamin D prescription ranged from 27% in Belgium to 75% in Sweden. Nearly all vitamin D prescriptions were administered intravenously in Spain versus about half in Italy; in all other countries, the route of active vitamin D administration was primarily oral. Patient age and dialysis vintage varied by country, potentially contributing to some of the observed country differences in MBD marker levels and treatment practices. Conclusion CKD-MBD related abnormalities in PTH, serum phosphorus and calcium remain common in European dialysis patients, with prevalence varying considerably by country. Substantial international variation in CKD-MBD treatments was also observed in prescription of vitamin D and calcimimetics. Uptake of the relatively new calcimimetic, etelcalcetide, varied considerably by country. A detailed understanding of the effect of treatment variation on CKD-MBD marker levels and patient outcomes is needed to provide important insights for the European HD community in optimizing management of secondary hyperparathyroidism.

scholarly journals Biochemical profile of mineral and bone disorder in prevalent hemodialysis patients

2019 ◽  
Vol 30 (3) ◽  
pp. 741
Author(s):  
SamirH Almueilo ◽  
FatimahR Alquraini ◽  
RababH Alnazer ◽  
OhoodA Albahrani ◽  
Ramlah Alkhars
Keyword(s):  
Hemodialysis Patients ◽  
Biochemical Profile ◽  
Mineral And Bone Disorder ◽  
Bone Disorder

Real World Use and Effects of Calcimimetics in Treating Mineral and Bone Disorder in Hemodialysis Patients

2020 ◽  
Vol 51 (10) ◽  
pp. 815-822
Author(s):  
Mark D. Danese ◽  
Deborah Lubeck ◽  
Vasily Belozeroff ◽  
Tzu-Chieh Lin ◽  
Pooja Desai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Index Date ◽  
Hemodialysis Patients ◽  
Mineral And Bone Disorder ◽  
Kaplan Meier ◽  
Bone Disorder ◽  
Over Time

<b><i>Background:</i></b> Calcimimetics are used to treat mineral and bone disorder by reducing parathyroid hormone (PTH), calcium (Ca), and phosphorus (Phos). The study objectives were to assess the control of PTH, Ca, and Phos over time in patients receiving cinacalcet or etelcalcetide as well as dosing and time to discontinuation for etelcalcetide. <b><i>Methods:</i></b> This was a retrospective cohort study using electronic medical records from small and independent dialysis centers. Adults ≥18 years of age were identified as cinacalcet or etelcalcetide users based on the first calcimimetic received in 2018 (index date). Patients were followed from the index date until parathyroidectomy, kidney transplant, death, or end of data (December 31, 2018). Analyses of mean PTH, Ca, and Phos, as well as target achievement of PTH, Ca, and Phos were conducted over a 9-month period. Discontinuation with etelcalcetide was measured with the Kaplan-Meier estimator. <b><i>Results:</i></b> There were 1,346 cinacalcet patients (mean age 60.5 years, 43.5% female, and 47.1% Black) and 1,255 etelcalcetide patients (mean age 63.4 years, 46.6% female, and 38.5% Black). At baseline, the proportions in target were similar for etelcalcetide versus cinacalcet: 36 versus 38% for PTH, 79 versus 80% for Ca, and 43 versus 44% for Phos. Overall, 40–47% of cinacalcet users and 48–62% of etelcalcetide users were observed to be in target for PTH over 9 months. The proportion in target for Phos ranged from 41 to 46% for cinacalcet and 46–51% for etelcalcetide. The proportion in target for Ca ranged from 74 to 78% for cinacalcet and 60–73% for etelcalcetide. Etelcalcetide 12-month discontinuation was 37.4%. <b><i>Conclusion:</i></b> Both calcimimetics were effective in keeping PTH, Ca, and Phos levels within target. Patients receiving etelcalcetide tended to have lower laboratory values for PTH, Ca, and Phos over time, while patients receiving cinacalcet tended to be more likely to be in target for Ca over time.

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