Abstract
The study investigated whether the type of bone disease management (aggressive versus conventional) had an impact on clinical outcomes, namely bone health measures (e.g., biointact parathyroid hormone [BiPTH], serum corrected calcium [cCa] level, serum phosphorus [phos] level, and corrected calcium-phosphorus product [cCaPO
4]).
Retrospective chart review of 173 closed medical records of maintenance hemodialysis patients on thrice-weekly therapy from January 1, 2005, through December 31, 2005. Two Conventional Management (i.e., control group) and three Aggressive Management (i.e., treatment group) dialysis facilities were enrolled.
There was a significant interaction for group assignment and BiPTH levels (
F = 4.12,
P = .01), with the Aggressive Group trending toward lower BiPTH levels than the Conventional Group. The Conventional Group experienced a significantly lower mean annualized serum cCa level (
F = 8.85,
P = .003), and used non–calcium-based binders significantly more (
P < .0005) than the Aggressive Group. In terms of serum phos level, the Aggressive Group had a significantly lower (
F = 2.73,
P = .05) value than the Conventional Group. No significant differences were reported for cCaPO
4 product (
F = 1.87,
P = .17). The percentage of the total sample that achieved target range for all bone health measures included 29.8% (n = 50).
The study demonstrated that aggressive bone disease management appears to be as effective as traditional interventions in the treatment of mineral and bone metabolism disorders in chronic kidney disease.