Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS).

Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Abstract Text:

BACKGROUND: Abnormalities in serum calcium, phosphorus, and parathyroid hormone (PTH) concentrations are common in patients with chronic kidney disease and have been associated with increased morbidity and mortality. No clinical trials have been conducted to clearly identify categories of calcium, phosphorus, and PTH levels associated with the lowest mortality risk. Current clinical practice guidelines are based largely on expert opinions, and clinically relevant differences exist among guidelines across countries. We sought to describe international trends in calcium, phosphorus, and PTH levels during 10 years and identify mortality risk categories in the Dialysis Outcomes and Practice Patterns Study (DOPPS), an international study of hemodialysis practices and associated outcomes. STUDY DESIGN: Prospective cohort study. PARTICIPANTS: 25,588 patients with end-stage renal disease on hemodialysis therapy for longer than 180 days at 925 facilities in DOPPS I (1996-2001), DOPPS II (2002-2004), or DOPPS III (2005-2007). PREDICTORS: Serum calcium, albumin-corrected calcium (Ca(Alb)), phosphorus, and PTH levels. OUTCOMES: Adjusted hazard ratios for all-cause and cardiovascular mortality calculated using Cox models. RESULTS: Distributions of mineral metabolism markers differed across DOPPS countries and phases, with lower calcium and phosphorus levels observed in the most recent phase of DOPPS. Survival models identified categories with the lowest mortality risk for calcium (8.6 to 10.0 mg/dL), Ca(Alb) (7.6 to 9.5 mg/dL), phosphorus (3.6 to 5.0 mg/dL), and PTH (101 to 300 pg/mL). The greatest risk of mortality was found for calcium or Ca(Alb) levels greater than 10.0 mg/dL, phosphorus levels greater than 7.0 mg/dL, and PTH levels greater than 600 pg/mL and in patients with combinations of high-risk categories of calcium, phosphorus, and PTH. LIMITATIONS: Because of the observational nature of DOPPS, this study can only indicate an association between mineral metabolism categories and mortality. CONCLUSIONS: Our results provide important information about mineral metabolism trends in hemodialysis patients in 12 countries during a decade. The risk categories identified in the DOPPS cohort may be relevant to efforts at international harmonization of existing clinical guidelines for mineral metabolism.

Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Publishing Authors By Initials

For similar abstracts research abstracts see: abstracts research

PUBMED ID PMID:

MEDLINE DATE:

Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Journal Published:

PUBLICATION TYPE: Journal Article

Journal: American journal of kidney diseases : the official

VOLUME: 52

Page Numbers: 519-30

Journal Abbreviation: Am. J. Kidney Dis.

ISSN: 1523-6838

DAY: 2

MONTH: 06

YEAR: 2008

Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 8110075

Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Keywords Mesh Terms:

KEYWORDS:

MESH TERMS:

Chemical & Substance for Abstract: Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS).

AFFILIATION: Arbor Research Collaborative for Health, University of Michigan, Ann Arbor, MI.

Country: United States

AGENCY:

GRANT:

ACRONYM:

MEDLINETA: Am J Kidney Dis

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study DOPPS Related Publications

• A sequential stratification method for estimating the effect of a time-dependent experimental treatment in observational studies.
• Association of mineral metabolism factors with all-cause and cardiovascular mortality in hemodialysis patients: the Japan dialysis outcomes and practice patterns study.
• Control of remembered reaching sequences in monkey. II. Storage and preparation before movement in motor and premotor cortex.
• Determinants of discard of expanded criteria donor kidneys: impact of biopsy and machine perfusion.
• Evaluation of dialysis performance measures.
• From the guest editors.
• Guiding contact by coupling the taus of gaps.
• High alkaline phosphatase levels in hemodialysis patients are associated with higher risk of hospitalization and death.
• Indicative symptoms: swelling of the neck. A study of differential diagnosis]
• Lack of appetite in haemodialysis patients associations with patient characteristics, indicators of nutritional status and outcomes in the international DOPPS.
• Mortality Risk for Dialysis Patients With Different Levels of Serum Calcium, Phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS).
• Reoperative sentinel lymph node biopsy after previous mastectomy.
• Sanders classification of fractures of the os calcis. An analysis of inter- and intra-observer variability.
• Sentinel lymph node biopsy is successful and accurate in male breast carcinoma.
• The treatment of distal femoral fractures in children using the LISS plate: a report of two cases.
• Timing is everything.
• Travel time to dialysis as a predictor of health-related quality of life, adherence, and mortality: the Dialysis Outcomes and Practice Patterns Study (DOPPS).
• Ultrasound detection of nonpalpable mammographically occult malignancy.
• Why words do not have a psychological alphabet.
• [Chronic rheumatism of the temporomandibular joints; its clinical manifestations and treatment]
• [DOPPS estimate of guideline impact on survival in hemodialysis in Italy.]
• [DOPPS estimate of patient life years attributable to modifiable hemodialysis practices in France.]
• [DOPPS estimate of patient life years attributable to modifiable hemodialysis practices in Spain]
• [Differential diagnosis of swellings of the external neck.]
• [Not Available.]
• miRNA expression in the failing human heart: functional correlates.