Impact of kidney bone disease and its management on survival of patients on dialysis.

Impact of kidney bone disease and its management on survival of patients on dialysis. Research Abstract Details 

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Impact of kidney bone disease and its management on survival of patients on dialysis. Abstract Text:

Grace H Lee,Deborah Benner,Deborah L Regidor,Kamyar Kalantar-Zadeh,

Despite the enormous cardiovascular disease epidemic and poor survival among individuals with chronic kidney disease (CKD), traditional risk factors such as hypercholesterolemia, hypertension, and obesity appear not as relevant as was previously thought, nor would their management improve survival in patients with CKD who are undergoing dialysis. On the contrary, kidney disease wasting (KDW) (also known as the malnutrition-inflammation complex), renal anemia, and kidney bone disease (KBD) appear to be the 3 most important nontraditional risk factors associated with cardiovascular disease in CKD. KBD-associated hyperparathyroidism may contribute to worsening refractory anemia and KDW/inflammation. The main cause of secondary hyperparathyroidism is active vitamin D deficiency. Hence, treatment of patients with KBD with vitamin D analogs, especially those with lesser effects on calcium and phosphorus such as paricalcitol, may be the most promising option for improving CKD outcomes. By conducting survival analyses in a 2-year (7/2001 to 6/2003) cohort of 58,058 patients on hemodialysis, we recently found that associations between high serum parathyroid hormone and increased death risk were masked by the demographic and clinical characteristics of patients, and that alkaline phosphatase had an incremental association with mortality. Administration of paricalcitol was associated with improved survival in time-varying models. We now present additional subgroup analyses that show that administration of any dose of paricalcitol, when compared with no paricalcitol, is associated with better likelihood of survival in virtually all subgroups of patients on hemodialysis. Because these associations may be secondary to bias by indication, randomized clinical trials are necessary to verify the findings of this and similar observational studies.

Impact of kidney bone disease and its management on survival of patients on dialysis. Publishing Authors By Initials

GH Lee,D Benner,DL Regidor,K Kalantar-Zadeh,

For similar polycyclic compounds: steroids: secosteroids: vitamin d research abstracts see: polycyclic compounds: steroids: secosteroids: vitamin d research

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Impact of kidney bone disease and its management on survival of patients on dialysis. Journal Published:

PUBLICATION TYPE: Review

Journal: Journal of renal nutrition : the official journal

VOLUME: 17

Page Numbers: 38-44

Journal Abbreviation:

ISSN: 1532-8503

DAY: 3

MONTH: Jan

YEAR: 2007

Impact of kidney bone disease and its management on survival of patients on dialysis. Information

Number of References: 26

LANGUAGE: eng

NlmUniqueID: 9112938

Impact of kidney bone disease and its management on survival of patients on dialysis. Keywords Mesh Terms:

KEYWORDS: Vitamin D

MESH TERMS: therapeutic use

Chemical & Substance for Abstract: Impact of kidney bone disease and its management on survival of patients on dialysis. Information

Substance Name: Vitamin D

Registry Number: 1406-16-2

Grant and Affiliation Information for Impact of kidney bone disease and its management on survival of patients on dialysis.

AFFILIATION: Department of Pharmacy, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California 90502, USA.

Country: United States

AGENCY: United States NIDDK

GRANT: DK61162

ACRONYM: DK

MEDLINETA: J Ren Nutr

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