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Improvement of mineral and bone metabolism markers is associated with better survival in haemodialysis patients: The COSMOS study

dc.contributor.authorFernandez-Martin J.L.
dc.contributor.authorMartinez-Camblor P.
dc.contributor.authorDionisi M.P.
dc.contributor.authorFloege J.
dc.contributor.authorKetteler M.
dc.contributor.authorLondon G.
dc.contributor.authorLocatelli F.
dc.contributor.authorGorriz J.L.
dc.contributor.authorRutkowski B.
dc.contributor.authorFerreira A.
dc.contributor.authorBos W.-J.
dc.contributor.authorCovic A.
dc.contributor.authorRodriguez-Garcia M.
dc.contributor.authorSanchez J.E.
dc.contributor.authorRodriguez-Puyol D.
dc.contributor.authorCannata-Andia J.B.
dc.date.accessioned2020-09-02T22:17:26Z
dc.date.available2020-09-02T22:17:26Z
dc.date.issued2015
dc.identifier10.1093/ndt/gfv099
dc.identifier.citation30, 9, 1542-1551
dc.identifier.issn09310509
dc.identifier.urihttps://hdl.handle.net/20.500.12728/4438
dc.descriptionBackground Abnormalities in serum phosphorus, calcium and parathyroid hormone (PTH) have been associated with poor survival in haemodialysis patients. This COSMOS (Current management Of Secondary hyperparathyroidism: a Multicentre Observational Study) analysis assesses the association of high and low serum phosphorus, calcium and PTH with a relative risk of mortality. Furthermore, the impact of changes in these parameters on the relative risk of mortality throughout the 3-year follow-up has been investigated. Methods COSMOS is a 3-year, multicentre, open-cohort, prospective study carried out in 6797 adult chronic haemodialysis patients randomly selected from 20 European countries. Results Using Cox proportional hazard regression models and penalized splines analysis, it was found that both high and low serum phosphorus, calcium and PTH were associated with a higher risk of mortality. The serum values associated with the minimum relative risk of mortality were 4.4 mg/dL for serum phosphorus, 8.8 mg/dL for serum calcium and 398 pg/mL for serum PTH. The lowest mortality risk ranges obtained using as base the previous values were 3.6-5.2 mg/dL for serum phosphorus, 7.9-9.5 mg/dL for serum calcium and 168-674 pg/mL for serum PTH. Decreases in serum phosphorus and calcium and increases in serum PTH in patients with baseline values of >5.2 mg/dL (phosphorus), >9.5 mg/dL (calcium) and <168 pg/mL (PTH), respectively, were associated with improved survival. Conclusions COSMOS provides evidence of the association of serum phosphorus, calcium and PTH and mortality, and suggests survival benefits of controlling chronic kidney disease-mineral and bone disorder biochemical parameters in CKD5D patients. © 2015 The Author.
dc.language.isoen
dc.publisherOxford University Press
dc.subjectCalcium
dc.subjectchronic kidney disease
dc.subjectCKD-MBD
dc.subjectcosmos
dc.subjecthemodialysis
dc.subjectphosphorous
dc.subjectPTH
dc.subjectsurvival
dc.subjectcalcium
dc.subjectparathyroid hormone
dc.subjectphosphate
dc.subjectbiological marker
dc.subjectcalcium
dc.subjectparathyroid hormone
dc.subjectphosphorus
dc.subjectadult
dc.subjectArticle
dc.subjectbone metabolism
dc.subjectbone mineral
dc.subjectdisease association
dc.subjectfemale
dc.subjecthemodialysis
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmortality
dc.subjectphosphate blood level
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectrisk factor
dc.subjectsurvival
dc.subjectblood
dc.subjectbone
dc.subjectclinical trial
dc.subjectcontrolled study
dc.subjectepidemiology
dc.subjectEurope
dc.subjectfollow up
dc.subjectmetabolism
dc.subjectmiddle aged
dc.subjectmortality
dc.subjectmulticenter study
dc.subjectprognosis
dc.subjectproportional hazards model
dc.subjectrandomized controlled trial
dc.subjectRenal Insufficiency, Chronic
dc.subjectrenal replacement therapy
dc.subjectsecondary hyperparathyroidism
dc.subjectsurvival rate
dc.subjectAdult
dc.subjectBiomarkers
dc.subjectBone and Bones
dc.subjectCalcium
dc.subjectEurope
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectHyperparathyroidism, Secondary
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectParathyroid Hormone
dc.subjectPhosphorus
dc.subjectPrognosis
dc.subjectProportional Hazards Models
dc.subjectProspective Studies
dc.subjectRenal Dialysis
dc.subjectRenal Insufficiency, Chronic
dc.subjectSurvival Rate
dc.titleImprovement of mineral and bone metabolism markers is associated with better survival in haemodialysis patients: The COSMOS study
dc.typeArticle


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