Repository logo
 
Publication

Improvement of Mineral and Bone Metabolism Markers Is Associated with Better Survival in Haemodialysis Patients: the COSMOS Study

2015-09Journal article Open access
Simple item page
dc.contributor.authorFernández-Martín, JL
dc.contributor.authorMartínez-Camblor, P
dc.contributor.authorDionisi, MP
dc.contributor.authorFloege, J
dc.contributor.authorKetteler, M
dc.contributor.authorLondon, G
dc.contributor.authorLocatelli, F
dc.contributor.authorGorriz, JL
dc.contributor.authorRutkowski, B
dc.contributor.authorFerreira, A
dc.contributor.authorBos, WJ
dc.contributor.authorCovic, A
dc.contributor.authorRodríguez-García, M
dc.contributor.authorSánchez, JE
dc.contributor.authorRodríguez-Puyol, D
dc.contributor.authorCannata-Andia, JB
dc.date.accessioned2016-06-17T15:36:30Z
dc.date.available2016-06-17T15:36:30Z
dc.date.issued2015-09
dc.description.abstractBACKGROUND: Abnormalities in serum phosphorus, calcium and parathyroid hormone (PTH) have been associated with poor survival in haemodialysis patients. This COSMOS (Current management Of Secondary hyperparathyroidism: a Multicentre Observational Study) analysis assesses the association of high and low serum phosphorus, calcium and PTH with a relative risk of mortality. Furthermore, the impact of changes in these parameters on the relative risk of mortality throughout the 3-year follow-up has been investigated. METHODS:COSMOS is a 3-year, multicentre, open-cohort, prospective study carried out in 6797 adult chronic haemodialysis patients randomly selected from 20 European countries. RESULTS:Using Cox proportional hazard regression models and penalized splines analysis, it was found that both high and low serum phosphorus, calcium and PTH were associated with a higher risk of mortality. The serum values associated with the minimum relative risk of mortality were 4.4 mg/dL for serum phosphorus, 8.8 mg/dL for serum calcium and 398 pg/mL for serum PTH. The lowest mortality risk ranges obtained using as base the previous values were 3.6-5.2 mg/dL for serum phosphorus, 7.9-9.5 mg/dL for serum calcium and 168-674 pg/mL for serum PTH. Decreases in serum phosphorus and calcium and increases in serum PTH in patients with baseline values of >5.2 mg/dL (phosphorus), >9.5 mg/dL (calcium) and <168 pg/mL (PTH), respectively, were associated with improved survival. CONCLUSIONS:COSMOS provides evidence of the association of serum phosphorus, calcium and PTH and mortality, and suggests survival benefits of controlling chronic kidney disease-mineral and bone disorder biochemical parameters in CKD5D patients.pt_PT
dc.identifier.citationNephrol Dial Transplant. 2015 Sep;30(9):1542-51pt_PT
dc.identifier.doi10.1093/ndt/gfv099pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2515
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Presspt_PT
dc.subjectAdultpt_PT
dc.subjectBiomarkers/bloodpt_PT
dc.subjectBone and Bones/metabolismpt_PT
dc.subjectCalcium/bloodpt_PT
dc.subjectEurope/epidemiologypt_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHumanspt_PT
dc.subjectHyperparathyroidism, Secondary/bloodpt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectParathyroid Hormone/bloodpt_PT
dc.subjectPhosphorus/bloodpt_PT
dc.subjectPrognosispt_PT
dc.subjectProportional Hazards Modelspt_PT
dc.subjectProspective Studiespt_PT
dc.subjectRenal Dialysis/mortalitypt_PT
dc.subjectRenal Insufficiency, Chronic/therapypt_PT
dc.subjectSurvival Ratept_PT
dc.subjectHCC NEFpt_PT
dc.subjectHyperparathyroidism, Secondary/mortalitypt_PT
dc.titleImprovement of Mineral and Bone Metabolism Markers Is Associated with Better Survival in Haemodialysis Patients: the COSMOS Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1551pt_PT
oaire.citation.issue9pt_PT
oaire.citation.startPage1542pt_PT
oaire.citation.titleNephrology, Dialysis, Transplantationpt_PT
oaire.citation.volume30pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

Files

Collections

NEF - Artigos