ArticleKidney medicine
International and Racial Differences in Mineral and Bone Disorder Markers and Treatments Over the First 5 Years of Hemodialysis in the Dialysis Outcomes and Practice Patterns Study.
Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Dialysate calcium, alfacalcidol, and clinical outcomes: A post-hoc analysis of the J-DAVID trial.PloS one · 2022Trial
- Treatment of secondary hyperparathyroidism in hemodialysis patients: a comparison between two Italian centers to evaluate real-world guideline implementation.Journal of nephrology · 2025Article
- Is thymectomy necessary during parathyroidectomy for secondary hyperparathyroidism in patients with end-stage kidney disease?Surgery · 2025Article
- Association Between Disturbed Serum Phosphorus Levels and QT Interval Prolongation.Kidney international reports · 2024Article
- Article
- Serum parathyroid hormone trajectory during the first year of hemodialysis: a roadmap to severe hyperparathyroidism.Jornal brasileiro de nefrologiaArticle
- Secondary hyperparathyroidism: what we know and what we are still learning.Jornal brasileiro de nefrologiaArticle
- Secondary hyperparathyroidism due to chronic kidney disease and access to clinical treatment and parathyroidectomy in Brazil: a nationwide survey.Jornal brasileiro de nefrologiaArticle
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
RATIONALE &
objectiveNormalization of parathyroid hormone (PTH), serum calcium, and phosphorus levels may prevent coronary and bone disease in hemodialysis (HD) patients. We describe the trajectory of these mineral bone disorder parameters and treatments during the first 5 years of HD by international region and race. STUDY
designProspective cohort study. SETTING &
participants33,517 US black/African American, US non-black/African American, European, and Japanese HD patients from the Dialysis Outcomes and Practice Patterns Study (DOPPS) phases 4 to 5 (2009-2015). PREDICTOR: Time since HD initiation. OUTCOMES: Monthly cross-sections of mineral bone disorder parameters (PTH, serum calcium, and phosphorus) and medications (cinacalcet, active vitamin D, and phosphate binders).
resultsMean PTH levels declined precipitously during the first 4 months of HD in all 4 groups, then steadily increased during the next 4.5 years in the United States/Europe but not in Japan. 3 years after HD initiation (month 36), mean PTH level was highest in US black/African Americans (496 pg/mL), despite greater prescription of cinacalcet (23%) and active vitamin D (85%), and lowest in Japan (151 pg/mL). Mean serum calcium and phosphorus levels increased during the first 4 months of HD. By month 36, the mean calcium level was lower in Japan (8.8 mg/dL) than United States/Europe (9.0-9.1 mg/dL), while the mean phosphorus level was lower in Europe (4.8 mg/dL) than United States/Japan (5.1-5.3 mg/dL). LIMITATIONS: Lack of data for medication dosages; most patients were not followed from HD onset.
conclusionsLarge differences exist in the levels, trajectories, and therapies for PTH, calcium, and phosphorus by country and race in the first 5 years of HD. Higher PTH levels were observed in the United States, especially among black/African American patients, despite greater use of cinacalcet and active vitamin D than in Japan or Europe. Potential contributors to differences in PTH levels should be explored to study their impact on PTH management strategies and consequent bone and cardiovascular complications.
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