2016年4月13日
PTH-dependence of the effectiveness of cinacalcet in hemodialysis patients with secondary hyperparathyroidism
Scientific Reports
- 巻
- 6
- 号
- 開始ページ
- 19612
- 終了ページ
- 19612
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1038/srep19612
- 出版者・発行元
- NATURE PUBLISHING GROUP
Cinacalcet lowers parathyroid hormone levels. Whether it can prolong survival of people with chronic kidney disease (CKD) complicated by secondary hyperparathyroidism (SHPT) remains controversial, in part because a recent randomized trial excluded patients with iPTH < 300 pg/ml. We examined cinacalcet's effects at different iPTH levels. This was a prospective case-cohort and cohort study involving 8229 patients with CKD stage 5D requiring maintenance hemodialysis who had SHPT. We studied relationships between cinacalcet initiation and important clinical outcomes. To avoid confounding by treatment selection, we used marginal structural models, adjusting for time-dependent confounders. Over a mean of 33 months, cinacalcet was more effective in patients with more severe SHPT. In patients with iPTH >= 500 pg/ml, the reduction in the risk of death from any cause was about 50% (Incidence Rate Ratio [IRR] = 0.49; 95% Confidence Interval [95% CI]: 0.29-0.82). For a composite of cardiovascular hospitalization and mortality, the association was not statistically significant, but the IRR was 0.67 (95% CI: 0.43-1.06). These findings indicate that decisions about using cinacalcet should take into account the severity of SHPT.
- リンク情報
-
- DOI
- https://doi.org/10.1038/srep19612
- J-GLOBAL
- https://jglobal.jst.go.jp/detail?JGLOBAL_ID=201702202547321347
- PubMed
- https://www.ncbi.nlm.nih.gov/pubmed/27071541
- PubMed Central
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4829837
- Web of Science
- https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000373965500001&DestApp=WOS_CPL
- Scopus
- https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84963956655&origin=inward 本文へのリンクあり
- Scopus Citedby
- https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84963956655&origin=inward
- ID情報
-
- DOI : 10.1038/srep19612
- ISSN : 2045-2322
- eISSN : 2045-2322
- J-Global ID : 201702202547321347
- PubMed ID : 27071541
- PubMed Central 記事ID : PMC4829837
- SCOPUS ID : 84963956655
- Web of Science ID : WOS:000373965500001