Cannata-Andía Jorge B, Fernández-Martín José Luis, Zoccali Carmine, London Gérard M, Locatelli Francesco, Ketteler Markus, Ferreira Aníbal, Covic Adrian, Floege Jürgen, Górriz José Luis, Rutkowski Boleslaw, Memmos Dimitrios E, Verbeelen Dierik, Tielemans Christian, Teplan Vladimir, Bos Willem Jan, Nagy Judit, Kramar Reinhard, Goldsmith David J A, Martin Pierre-Yves, Wüthrich Rudolf P, Pavlovic Drasko, Benedik Mihael
Servicio de Metabolismo Oseo y Mineral, Instituto Reina Sofía de Investigación, Hospital Universitario Central de Asturias, Oveido, Spain.
J Nephrol. 2008 May-Jun;21(3):290-8.
To survey bone mineral disturbances in the hemodialysis (HD) population in Europe and current clinical practice in Europe for the prevention, diagnosis and treatment of secondary hyperparathyroidism (SHPT) in HD patients.
First, to estimate the prevalence of Kidney Disease Outcomes Quality Initiative (K/DOQI) guideline achievement in a representative sample of European hemodialysis subjects. As part of this objective, we will investigate the prevalence of achievement by type of dialysis, type of center and time on dialysis (less than or greater than 1 year). Among new dialysis subjects (less than 1 year), we will evaluate prevalence of K/DOQI target achievement until the end of the study. The study will run for 3 years. Second, to estimate the association of bone mineral markers (parathyroid hormone [PTH], calcium [Ca], serum phosphorus [P] and calcium phosphate product [CaxP]) classified by achievement of K/DOQI targets with mortality and overall cardiovascular hospitalization. Third, to characterize the longitudinal changes in bone mineral markers. As part of this objective, we will describe the patterns and predictors of bone mineral markers and achievement, with K/DOQI targets, using repeated measurements on individuals over time.
First, To estimate the association of bone mineral markers (PTH, Ca, P and CaxP) classified by achievement of K/DOQI targets with specific cardiovascular outcomes, parathyroidectomy, manifest bone disease (including incidence of symptomatic bone fractures), hospitalizations and vascular access. Second, to evaluate the additional value of albumin and hemoglobin levels in conjunction with bone mineral markers in the prediction of mortality and clinical events.
调查欧洲血液透析（HD）人群的骨矿物质紊乱情况以及欧洲目前针对HD患者继发性甲状旁腺功能亢进（SHPT）的预防、诊断和治疗的临床实践。
第一，在欧洲血液透析受试者的代表性样本中估计达到肾脏病预后质量倡议（K/DOQI）指南的比例。作为该目标的一部分，我们将按透析类型、中心类型和透析时间（少于或多于1年）调查达到指南的比例。在新透析受试者（少于1年）中，我们将评估到研究结束时达到K/DOQI目标的比例。该研究将持续3年。第二，估计根据是否达到K/DOQI目标分类的骨矿物质标志物（甲状旁腺激素[PTH]、钙[Ca]、血清磷[P]和钙磷乘积[CaxP]）与死亡率和总体心血管住院率之间的关联。第三，描述骨矿物质标志物的纵向变化。作为该目标 的一部分，我们将通过对个体进行随时间的重复测量，描述骨矿物质标志物及其达到K/DOQI目标的模式和预测因素。
第一，估计根据是否达到K/DOQI目标分类的骨矿物质标志物（PTH、Ca、P和CaxP）与特定心血管结局、甲状旁腺切除术、明显骨病（包括有症状骨折的发生率）、住院和血管通路之间的关联。第二，评估白蛋白和血红蛋白水平结合骨矿物质标志物在预测死亡率和临床事件方面的附加价值。
