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Bone Marker Control Benefits Hemodialysis Patients

Survival benefit linked to meeting target levels for parathyroid hormone, calcium, phosphorus

THURSDAY, July 3 (HealthDay News) -- In hemodialysis patients, consistent control of three markers for mineral and bone disorders -- parathyroid hormone, calcium and phosphorus -- within guidelines established by the National Kidney Foundation is a strong predictor of survival, according to a report published online July 2 in the Clinical Journal of the American Society of Nephrology.

Mark D. Danese, M.D., of Outcomes Insights, Inc., in Newbury Park, Calif., and colleagues studied 22,937 patients who initiated hemodialysis at Fresenius Medical Care-North America in Lexington, Mass., between July 1, 2000 and June 30, 2002, and followed them through June 30, 2004.

Compared to patients who met target levels for all three markers, the researchers found that the risk of death was significantly higher in those who achieved none, one or two of the markers (51 percent, 35-39 percent, and 15-21 percent, respectively). In their time-to-target analysis, they found that the risk of death was 25 percent lower in patients who met target levels of parathyroid hormone for all four quarters than in those who only did so for less than one quarter. Patients who met target levels of calcium and phosphorus had lower risks of 14 percent and 38 percent, respectively.

"It is possible that maintenance of the Kidney Disease Outcomes Quality Initiative targets for parathyroid hormone, calcium and phosphorus could reduce mortality in hemodialysis patients by as much as 20 percent," the authors conclude.

This study was supported by Amgen, and several of the study authors have financial ties to Amgen.

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