RT Journal Article
T1 Anti-parathyroid treatment effectiveness and persistence in incident haemodialysis patients with secondary hyperparathyroidism
A1 Martin de Francisco, Angel Luis
A1 Gillespie, Iain Andrew
A1 Gioni, Ioanna
A1 Floege, Juergen
A1 Kronenberg, Florian
A1 Marcelli, Daniele
A1 Wheelers, David Collins
A1 Froissart, Marc
A1 Drueke, Tilman Bernhard
A1 ARO Steering Comm Cllaborators, 
K1 Chronic kidney disease
K1 Chronic kidney disease-mineral and bone disorder
K1 Haemo dialysis
K1 Secondary hyperparathyroidism
K1 Treatment initiation
K1 Treatment persistence
K1 Treatment discontinuation
K1 Mortality risk
K1 Calcimimetic amg-073
K1 Cinacalcet
K1 Association
K1 Disease
K1 Paricalcitol
K1 Phosphorus
K1 Adherence
K1 Outcomes
K1 Hormone
AB Background: Anti-parathyroid treatment initiation and discontinuation are important decisions in chronic haemodialysis (HD) patients, where pill burden is often excessive. The present study aimed to describe secondary hyperparathyroidism (sHPT) drug therapy changes in HD patients.Methods: Retrospective observational cohort study of incident European HD patients with sHPT who were prescribed calcitriol or alfacalcidol (alpha calcitriol), paricalcitol or cinacalcet.Results: Treatment-naive patients prescribed alpha calcitriol (N=2259), paricalcitol (N=1689)and cinacalcet (N = 1245) were considered for analysis. Serum intact parathyroid hormone (iPTH) levels decreased post-initiation with all treatment modalities; serum calcium and phosphate levels increased in response to activated vitamin D derivatives but decreased with cinacalcet. Approximately one-third of alpha calcitriol and paricalcitol patients but less than one-quarter of cinacalcet patients discontinued treatment. Although the three groups had comparable serum iPTH control at the time of treatment discontinuation, they differed in terms of calcium and phosphate levels. Following discontinuation, the evolution differed by treatment modality: whilst iPTH increased for all three treatment groups, calcium and phosphate decreased in patients who were being treated with alpha calcitriol and paricalcitol at the time of discontinuation, and increased in those who had been treated with cinacalcet.Conclusions: In conditions of daily clinical practice, attaining and maintaining recommended biochemical control of sHPT appears to be more frequently achievable with cinacalcet than with activated vitamin D compounds. (C) 2015 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.
PB Soc espanola nefrologia dr rafael matesanz
SN 0211-6995
YR 2016
FD 2016-03-01
LK https://hdl.handle.net/10668/25373
UL https://hdl.handle.net/10668/25373
LA en
DS RISalud
RD Apr 11, 2025