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Survival of Patients Undergoing Hemodialysis with Paricalcitol or Calcitriol Therapy
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Survival of Patients Undergoing Hemodialysis with Paricalcitol or Calcitriol Therapy
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Journal Article
Survival of Patients Undergoing Hemodialysis with Paricalcitol or Calcitriol Therapy
2003
Overview
Elevated calcium and phosphorus levels associated with secondary hyperparathyroidism may accelerate vascular disease in patients undergoing long-term hemodialysis. This prospective but nonrandomized historical cohort study compared calcitriol, the standard injectable therapy, with paricalcitol, a new vitamin D analogue that causes less elevation of calcium. Paricalcitol was associated with a lower mortality rate than calcitriol (0.180 vs. 0.223 death per person-year).
The one-year mortality rate among patients undergoing hemodialysis in the United States approaches 20 percent, and mortality rates among patients undergoing hemodialysis at every age exceed the rates among those not undergoing hemodialysis.
1
,
2
Methods to improve survival include increased doses of dialysis,
3
,
4
improved nutrition,
5
and management of anemia,
6
but the mortality rates remain high, despite considerable efforts targeting these factors.
7
Cardiovascular disease is the predominant cause of dialysis-related mortality.
2
Recently, the effect of secondary hyperparathyroidism and its management on vascular disease has garnered substantial attention.
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–
12
Parenteral vitamin D effectively suppresses parathyroid hormone secretion and is therefore standard . . .
Publisher
Massachusetts Medical Society
Subject
/ Aged
/ Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
/ Biological and medical sciences
/ Calcitriol - therapeutic use
/ Chronic Kidney Disease-Mineral and Bone Disorder - prevention & control
/ Disease
/ Emergency and intensive care: renal failure. Dialysis management
/ Ergocalciferols - therapeutic use
/ Female
/ Humans
/ Hyperparathyroidism - drug therapy
/ Hyperparathyroidism - etiology
/ Kidney Failure, Chronic - blood
/ Kidney Failure, Chronic - mortality
/ Kidney Failure, Chronic - therapy
/ Male
