Population-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-PTH levels: a case-cohort study

Abstract Achieving calcium, phosphorus, and intact parathyroid hormone (PTH) targets helps improve dialysis population outcomes. We aimed to assess the population-level associations of achievement of those targets with survival using population-attributable-fractions (PAFs). We conducted a case-coho...

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Autores principales:	Shingo Fukuma, Shunichi Fukuhara, Sayaka Shimizu, Tadao Akizawa, Masafumi Fukagawa
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2019
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d16dec41635b484c91009e9e1dd6353d
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spelling	oai:doaj.org-article:d16dec41635b484c91009e9e1dd6353d2021-12-02T15:07:55ZPopulation-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-PTH levels: a case-cohort study10.1038/s41598-019-47852-82045-2322https://doaj.org/article/d16dec41635b484c91009e9e1dd6353d2019-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-019-47852-8https://doaj.org/toc/2045-2322Abstract Achieving calcium, phosphorus, and intact parathyroid hormone (PTH) targets helps improve dialysis population outcomes. We aimed to assess the population-level associations of achievement of those targets with survival using population-attributable-fractions (PAFs). We conducted a case-cohort study using data from 8229 haemodialysis patients with mildly elevated intact PTH, treated at 86 dialysis facilities in Japan. We examined associations among calcium, phosphorus, intact PTH, and mortality over 3 years. We estimated PAFs for achieving the targets of calcium, phosphorus, and intact PTH from the adjusted hazard ratios by Cox regression models. Proportions within the recommended range were 55.8%, 63.3%, and 39.1% for calcium (8.4–10.0 mg/dL), phosphorus (3.5–6.0 mg/dL) and intact PTH (60–240 pg/mL), respectively. The mortality rate was 5.7 per 100 person-years. Mortality was independently associated with non-achievement of targets. Regarding the population-level impact, statistically significant PAFs were found for achieving the combination of calcium and phosphorus (8.8%; 95% CI, 1.1–16.0). Further, PAF for combined calcium, phosphorus, and intact PTH was the largest (16.8%; 95% CI, 5.6–30.4). In conclusion, there might be additive and substantial population-level associations between survival and the achievement of calcium, phosphorus, and intact-PTH targets in the haemodialysis population with mildly elevated intact PTH.Shingo FukumaShunichi FukuharaSayaka ShimizuTadao AkizawaMasafumi FukagawaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 9, Iss 1, Pp 1-7 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shingo Fukuma Shunichi Fukuhara Sayaka Shimizu Tadao Akizawa Masafumi Fukagawa Population-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-PTH levels: a case-cohort study
description	Abstract Achieving calcium, phosphorus, and intact parathyroid hormone (PTH) targets helps improve dialysis population outcomes. We aimed to assess the population-level associations of achievement of those targets with survival using population-attributable-fractions (PAFs). We conducted a case-cohort study using data from 8229 haemodialysis patients with mildly elevated intact PTH, treated at 86 dialysis facilities in Japan. We examined associations among calcium, phosphorus, intact PTH, and mortality over 3 years. We estimated PAFs for achieving the targets of calcium, phosphorus, and intact PTH from the adjusted hazard ratios by Cox regression models. Proportions within the recommended range were 55.8%, 63.3%, and 39.1% for calcium (8.4–10.0 mg/dL), phosphorus (3.5–6.0 mg/dL) and intact PTH (60–240 pg/mL), respectively. The mortality rate was 5.7 per 100 person-years. Mortality was independently associated with non-achievement of targets. Regarding the population-level impact, statistically significant PAFs were found for achieving the combination of calcium and phosphorus (8.8%; 95% CI, 1.1–16.0). Further, PAF for combined calcium, phosphorus, and intact PTH was the largest (16.8%; 95% CI, 5.6–30.4). In conclusion, there might be additive and substantial population-level associations between survival and the achievement of calcium, phosphorus, and intact-PTH targets in the haemodialysis population with mildly elevated intact PTH.
format	article
author	Shingo Fukuma Shunichi Fukuhara Sayaka Shimizu Tadao Akizawa Masafumi Fukagawa
author_facet	Shingo Fukuma Shunichi Fukuhara Sayaka Shimizu Tadao Akizawa Masafumi Fukagawa
author_sort	Shingo Fukuma
title	Population-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-PTH levels: a case-cohort study
title_short	Population-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-PTH levels: a case-cohort study
title_full	Population-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-PTH levels: a case-cohort study
title_fullStr	Population-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-PTH levels: a case-cohort study
title_full_unstemmed	Population-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-PTH levels: a case-cohort study
title_sort	population-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-pth levels: a case-cohort study
publisher	Nature Portfolio
publishDate	2019
url	https://doaj.org/article/d16dec41635b484c91009e9e1dd6353d
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Population-level associations of achievement of targets for bone-mineral markers with survival in haemodialysis patients with mildly elevated intact-PTH levels: a case-cohort study

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