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dc.contributor.authorCraver Hospital, Lourdes
dc.contributor.authorMarco Mayayo, M. Paz
dc.contributor.authorMartínez, Isabel
dc.contributor.authorRué i Monné, Montserrat
dc.contributor.authorBorràs, Mercè
dc.contributor.authorMartín Ramos, María Luisa
dc.contributor.authorSarró, Felipe
dc.contributor.authorValdivielso Revilla, José Manuel
dc.contributor.authorFernández i Giráldez, Elvira
dc.date.accessioned2016-06-02T07:37:08Z
dc.date.issued2007
dc.identifier.issn0931-0509
dc.identifier.urihttp://hdl.handle.net/10459.1/57147
dc.description.abstractBACKGROUND: Dialysis Outcomes and Practice Patterns Study has shown that the proportion of haemodialysis patients with adequate mineral metabolism parameters according to the Kidney Disease Outcome Quality Initiative (K/DOQI) guidelines is very low. The adequacy of such parameters in relation to the recommended ranges in patients with different chronic kidney disease (CKD) stages has not been reported. The objective of this study is to provide an in-depth description of mineral metabolism in the early stages of CKD in a European population, and to compare it with current recommendations for stages 3-5 (K/DOQI guidelines). METHODS: A total of 1836 patients were classified into stages 1-5 according to K/DOQI guidelines. The following clinical and biochemical data were recorded: age, gender, CKD aetiology, presence of diabetes, serum creatinine, creatinine clearance, serum phosphate, calcium, CaxP product and intact parathyroid hormone (PTH). RESULTS: A decrease in 1,25-dihydroxyvitamin D and an increase in PTH are the earliest mineral metabolism alterations in CKD, while serum calcium and phosphate are altered later in the course of CKD. The percentages of patients with serum levels within the recommended K/DOQI guidelines for stages 3, 4 and 5 were as follows: serum calcium: 90.7, 85.6 and 55; serum phosphate: 90.9, 77.1 and 70.3; iPTH 42.4, 24.6 and 46.8 and Ca x P product 99.9, 99.6 and 83.8, respectively. The percentages of patients who had all four parameters within the recommended ranges were 34.9, 18.4 and 21.6 for stages 3, 4 and 5, respectively. CONCLUSION: Mineral metabolism disturbances start early in the course of CKD. The first alterations to take place are a 1,25-dihydroxyvitamin D decrease, a 24 h urine phosphate decrease and a PTH elevation, which show significant level variation when the glomerular filtration rate falls below 60 ml/min. K/DOQI recommended levels for mineral metabolism parameters are difficult to accomplish, in particular for PTH levels.ca_ES
dc.language.isoengca_ES
dc.publisherOxford University Pressca_ES
dc.relation.isformatofReproducció del document publicat a https://doi.org/10.1093/ndt/gfl718ca_ES
dc.relation.ispartofNephrology Dialysis Transplantation, 2007, vol. 22, núm. 4, p. 1171-1176ca_ES
dc.rights(c) Oxford University Press, 2007ca_ES
dc.subjectAdequacyca_ES
dc.subjectCalciumca_ES
dc.subjectChronic renal diseaseca_ES
dc.subjectGuidelinesca_ES
dc.titleMineral metabolism parameters throughout chronic kidney disease stages 1–5—achievement of K/DOQI target rangesca_ES
dc.typearticleca_ES
dc.identifier.idgrec011980
dc.type.versionpublishedVersionca_ES
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccessca_ES
dc.identifier.doihttps://doi.org/10.1093/ndt/gfl718
dc.date.embargoEndDate10000-01-01


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