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Nitta Kosaku
Department Other, Other Position |
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| Article types | Original article |
| Language | English |
| Peer review | Non peer reviewed |
| Title | International variations in serum PTH and calcium levels and their mortality associations in peritoneal dialysis patients: Results from PDOPPS |
| Journal | Formal name：Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis Abbreviation：Perit Dial Int ISSN code：17184304/08968608 |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | pp.online |
| Author and coauthor | Nitta Kosaku, Bieber Brian, Karaboyas Angelo, Johnson David W, Kanjanabuch Talerngsak, Kim Yong-Lim, Lambie Mark, Hartman John, Shen Jenny I, Naljayan Mihran, Pecoits-Filho Roberto, Robinson Bruce M, Pisoni Ronald L, Perl Jeffrey, Kawanishi Hideki |
| Authorship | Lead author |
| Publication date | 2024/03/19 |
| Summary | BACKGROUND:Mineral bone disorder (MBD) in chronic kidney disease (CKD) is associated with high symptom burden, fractures, vascular calcification, cardiovascular disease and increased morbidity and mortality. CKD-MBD studies have been limited in peritoneal dialysis (PD) patients. Here, we describe calcium and parathyroid hormone (PTH) control, related treatments and mortality associations in PD patients.METHODS:We used data from eight countries (Australia and New Zealand (A/NZ), Canada, Japan, Thailand, South Korea, United Kingdom, United States (US)) participating in the prospective cohort Peritoneal Dialysis Outcomes and Practice Patterns Study (2014-2022) among patients receiving PD for >3 months. We analysed the association of baseline PTH and albumin-adjusted calcium (calciumAlb) with all-cause mortality using Cox regression, adjusted for potential confounders, including serum phosphorus and alkaline phosphatase.RESULTS:Mean age ranged from 54.6 years in South Korea to 63.5 years in Japan. PTH and serum calciumAlb were measured at baseline in 12,642 and 14,244 patients, respectively. Median PTH ranged from 161 (Japan) to 363 pg/mL (US); mean calciumAlb ranged from 9.1 (South Korea, US) to 9.8 mg/dL (A/NZ). The PTH/mortality relationship was U-shaped, with the lowest risk at PTH 300-599 pg/mL. Mortality was nearly 20% higher at serum calciumAlb 9.6+ mg/dL versus 8.4-<9.6 mg/dL. MBD therapy prescriptions varied substantially across countries.CONCLUSIONS:A large proportion of PD patients in this multi-national study have calcium and/or PTH levels in ranges associated with substantially higher mortality. These observations point to the need to substantially improve MBD management in PD to optimise patient outcomes.LAY SUMMARY:Chronic kidney disease-mineral bone disorder (MBD) is a systemic condition, common in dialysis patients, that results in abnormalities in parathyroid hormone (PTH), calcium, phosphorus and vitamin D metabolism. A large proportion of peritoneal |
| DOI | 10.1177/08968608241235516 |
| PMID | 38501163 |