Title |
Effect of VDRA on survival in incident hemodialysis patients: results of the FARO-2 observational study
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Published in |
BMC Nephrology, February 2015
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DOI | 10.1186/s12882-015-0006-8 |
Pubmed ID | |
Authors |
Piergiorgio Messa, Mario Cozzolino, Diego Brancaccio, Giuseppe Cannella, Fabio Malberti, Anna Maria Costanzo, Umberto di Luzio Paparatti, Vincenzo Festa, Giuliana Gualberti, Sandro Mazzaferro, on behalf of the FARO Study Group |
Abstract |
Mortality rate among patients with stage five chronic kidney disease (CKD) maintained on hemodialysis (HD) is high. Although evidence suggests that use of Vitamin D Receptor Activators (VDRA) in CKD patients increases survival, few studies have examined the effect of VDRA in incident HD patients. The FARO-2 study evaluated the clinical outcome of VDRA therapy on mortality in incident HD patients. FARO-2 was a longitudinal epidemiological study performed on 568 incident HD patients followed prospectively from 26 dialysis centers over a 3-year period. Data were collected every 6 months using a questionnaire, obtaining clinical, biochemical and therapeutic parameters. Kaplan-Meier curves and Cox proportional hazard regression models were used to determine cumulative probability of time-to-death and adjusted hazard ratios. 568 patients (68% male) with an average age of 65.5 years were followed up. Mean dialysis duration at study entry was 3 months. VDRA use increased from 46% at 6 months to 54.7% at 36 months of follow-up (p = 0.08). No difference was observed in the presence of comorbid diseases at baseline in patients with and without VDRA therapy. Cumulative probability of survival at 24 months was 74.5% (95% CI: 70.2-78.3). Patients receiving VDRA therapy showed a significant increase in survival at 24 months (80.7%; 95% CI: 75.7-84.8) compared to those without (63.3%; 95% CI: 54.8-70.7, p <0.01). The presence of vascular disease, decreased hemoglobin, increased P and lack of VDRA treatment were significantly associated with an increased risk of mortality. Lack of VDRA treatment still remained significant as a predictor of mortality after adjusting for levels of PTH, P and Ca (HR = 2.16, 95% CI: 1.09-4.30, p = 0.03). Findings from FARO-2 indicate that in incident HD patients VDRA therapy was associated with increased survival. |
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Unknown | 2 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 35 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Master | 5 | 14% |
Student > Bachelor | 5 | 14% |
Student > Doctoral Student | 4 | 11% |
Other | 3 | 9% |
Researcher | 3 | 9% |
Other | 10 | 29% |
Unknown | 5 | 14% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 16 | 46% |
Nursing and Health Professions | 3 | 9% |
Unspecified | 2 | 6% |
Agricultural and Biological Sciences | 1 | 3% |
Psychology | 1 | 3% |
Other | 5 | 14% |
Unknown | 7 | 20% |