229 An Observational Analysis of Hospital Admissions and Total Member Costs Associated with the Use of Various Phosphate Binders Used in Dialysis Patients Included in ESCOs

2020 ◽  
Vol 75 (4) ◽  
pp. 602
Keyword(s):  
Hospital Admissions ◽  
Phosphate Binders ◽  
Dialysis Patients ◽  
Observational Analysis

Effects and safety of iron-based phosphate binders in dialysis patients: a systematic review and meta-analysis

Renal Failure ◽  
2014 ◽  
Vol 37 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Chun-Juan Zhai ◽  
Xin-Shuang Yu ◽  
Xiao-Wei Yang ◽  
Jing Sun ◽  
Rong Wang
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Phosphate Binders ◽  
Dialysis Patients ◽  
Iron Based

Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

2012 ◽  
Vol 27 (4) ◽  
pp. 325-329 ◽  
Author(s):  
David Howard ◽  
Rebecca Zhang ◽  
Yijian Huang ◽  
Nancy Kutner
Keyword(s):  
Hurricane Katrina ◽  
Large Scale ◽  
Service Use ◽  
Hospital Admissions ◽  
Gulf Coast ◽  
The United States ◽  
Time Varying ◽  
Dialysis Patients ◽  
Hospitalization Rates ◽  
The Impact

AbstractIntroductionDialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.ProblemThe impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.MethodsData from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.ResultsThe rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.ConclusionsHospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

Calcimimetics for the Treatment of Secondary Hyperparathyroidism in Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (2_suppl) ◽  
pp. 42-46 ◽  
Author(s):  
Jean Francis ◽  
David B. Simon ◽  
Peter Jeurgensen ◽  
Fredric O. Finkelstein
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
Secondary Hyperparathyroidism ◽  
Hormone Secretion ◽  
Phosphate Binders ◽  
Serum Phosphate Level ◽  
Dialysis Patients ◽  
Intravenous Vitamin ◽  
Stage Renal Disease ◽  
End Stage

Secondary hyperparathyroidism is a common complication in patients with end-stage renal disease. It has been associated with increased cardiovascular events and mortality. Traditional therapy has been based on vitamin D analogs and phosphate binders; but these therapies often do not control secondary hyperparathyroidism, particularly in peritoneal dialysis patients for whom phosphate clearances are limited and intravenous vitamin D is impractical. Cinacalcet, a calcimimetic, suppresses parathormone secretion by interacting with the calcium-sensing receptor on the surface of parathyroid gland cells. The resulting suppression of parathyroid hormone secretion produces a reduction in serum phosphate level and CaxPO4 product. The present paper reviews the efficacy of cinacalcet in the management of secondary hyperparathyroidism in peritoneal dialysis patients.

Are Calcium-Based Phosphate Binders Ever Preferable in Dialysis Patients?

2014 ◽  
Vol 27 (3) ◽  
pp. 269-272
Author(s):  
Nishank Jain ◽  
Robert F. Reilly
Keyword(s):  
Phosphate Binders ◽  
Dialysis Patients

scholarly journals A Study to Inform the Design of a National Multicentre Randomised Controlled Trial to Evaluate If Reducing Serum Phosphate to Normal Levels Improves Clinical Outcomes including Mortality, Cardiovascular Events, Bone Pain, or Fracture in Patients on Dialysis

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Ramya Bhargava ◽  
Philip A. Kalra ◽  
Paul Brenchley ◽  
Helen Hurst ◽  
Alastair Hutchison
Keyword(s):  
Randomised Controlled Trial ◽  
Clinical Outcomes ◽  
Cardiovascular Events ◽  
Controlled Trial ◽  
Drop Out ◽  
Phosphate Binders ◽  
Dialysis Patients ◽  
Definitive Trial ◽  
Registration Number ◽  
Randomised Controlled

Background. Retrospective, observational studies link high phosphate with mortality in dialysis patients. This generates research hypotheses but does not establish “cause-and-effect.” A large randomised controlled trial (RCT) of about 3000 patients randomised 50 : 50 to lower or higher phosphate ranges is required to answer the key question: does reducing phosphate levels improve clinical outcomes? Whether such a trial is technically possible is unknown; therefore, a study is necessary to inform the design and conduct of a future, definitive trial.Methodology. Dual centre prospective parallel group study: 100 dialysis patients randomized to lower (phosphate target 0.8 to 1.4 mmol/L) or higher range group (1.8 to 2.4 mmol/L). Non-calcium-containing phosphate binders and questionnaires will be used to achieve target phosphate. Primary endpoint: percentage successfully titrated to required range and percentage maintained in these groups over the maintenance period. Secondary endpoints: consent rate, drop-out rates, and cardiovascular events.Discussion. This study will inform design of a large definitive trial of the effect of phosphate on mortality and cardiovascular events in dialysis patients. If phosphate lowering improves outcomes, we would be reassured of the validity of this clinical practice. If, on the other hand, there is no improvement, a reassessment of resource allocation to therapies proven to improve outcomes will result.Trial Registration Number. This trial is registered with ISRCTN registration numberISRCTN24741445.

Calcitriol Pulse Therapy for Severe Hyperparathyroidism or Calcium Salts as Phosphate Binders in Renal Dialysis Patients?

Nephron ◽  
1995 ◽  
Vol 71 (3) ◽  
pp. 350-353 ◽  
Author(s):  
M. Gonella ◽  
G. Calabrese ◽  
A.G. Aleo ◽  
G. Vagelli ◽  
P. Deambrogio
Keyword(s):  
Renal Dialysis ◽  
Pulse Therapy ◽  
Phosphate Binders ◽  
Dialysis Patients ◽  
Calcium Salts

High Ferritin Level and Malnutrition Predict High Risk of Infection-Related Hospitalization in Incident Dialysis Patients: A Japanese Prospective Cohort Study

2016 ◽  
Vol 42 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Sawako Kato ◽  
Bengt Lindholm ◽  
Yukio Yuzawa ◽  
Yoshinari Tsuruta ◽  
Kana Nakauchi ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Hospital Admissions ◽  
Ferritin Level ◽  
Nutrition Status ◽  
Rank Test ◽  
Risk Of Infection ◽  
Dialysis Patients ◽  
Clinical Biomarkers ◽  
Kaplan Meier ◽  
Increased Risk

Aims: The aim of the study was to clarify the relationship between serum ferritin and infectious risks. Methods: We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. Results: Kaplan-Meier analysis revealed that the period without infections requiring hospitalization was significantly shorter in ferritin > median (82.0 ng/ml) group than in the ferritin < median group (log-rank test 4.44, p = 0.035). High ferritin was associated with significantly increased relative risk of hospitalization for infection (Cox hazard model 1.52, 95% CI 1.06-2.17). The number of hospitalization days was gradually longer in patients with high ferritin levels and malnutrition. Conclusion: Although serum ferritin levels were low, and doses of iron administered to dialysis patients in Japan are generally lower than in Western countries, an elevated ferritin level was associated with increased risk of infection, particularly in patients with poor nutritional status.

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