Serum Phosphorus Level Rises in US Hemodialysis Patients Over the Past Decade: A DOPPS Special Report
Mineral bone disorder (MBD) is a frequent consequence of chronic kidney disease, more so in patients with kidney failure treated by kidney replacement therapy. Despite the wide availability of interventions to control serum phosphate and parathyroid hormone levels, unmet gaps remain on optimal targe...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-02-01
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| Series: | Kidney Medicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590059522002175 |
| _version_ | 1811167265467400192 |
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| author | Murilo Guedes Brian Bieber Indranil Dasgupta Almudena Vega Kosaku Nitta Steven Brunelli John Hartman Jochen G. Raimann Bruce M. Robinson Ronald L. Pisoni |
| author_facet | Murilo Guedes Brian Bieber Indranil Dasgupta Almudena Vega Kosaku Nitta Steven Brunelli John Hartman Jochen G. Raimann Bruce M. Robinson Ronald L. Pisoni |
| author_sort | Murilo Guedes |
| collection | DOAJ |
| description | Mineral bone disorder (MBD) is a frequent consequence of chronic kidney disease, more so in patients with kidney failure treated by kidney replacement therapy. Despite the wide availability of interventions to control serum phosphate and parathyroid hormone levels, unmet gaps remain on optimal targets and best practices, leading to international practice pattern variations over time. In this Special Report, we describe international trends from the Dialysis Outcomes and Practice Patterns Study (DOPPS) for MBD biomarkers and treatments from 2002-2021, including data from a group of 7 European countries (Belgium, France, Germany, Italy, Spain, Sweden, United Kingdom), Japan, and the United States. From 2002-2012, mean phosphate levels declined in Japan (5.6 to 5.2 mg/dL), Europe (5.5 to 4.9 mg/dL), and the United States (5.7 to 5.0 mg/dL). Since then, levels rose in the United States (to mean 5.6 mg/dL, 2021), were stable in Japan (5.3 mg/dL), and declined in Europe (4.8 mg/dL). In 2021, 52% (United States), 27% (Europe), and 39% (Japan) had phosphate >5.5 mg/dL. In the United States, overall phosphate binder use was stable (80%-84% over 2015-2021), and parathyroid hormone levels rose only modestly. Although these results potentially stem from pervasive knowledge gaps in clinical practice, the noteworthy steady increase in serum phosphate in the United States over the past decades may be consequential to patient outcomes, an uncertainty that hopefully will soon be addressed by ongoing clinical trials. The DOPPS will continue to monitor international trends as new interventions and strategies ensue for MBD management in chronic kidney disease. |
| first_indexed | 2024-04-10T16:07:33Z |
| format | Article |
| id | doaj.art-d105c973b8da4721b4631af7dfad3ba9 |
| institution | Directory Open Access Journal |
| issn | 2590-0595 |
| language | English |
| last_indexed | 2024-04-10T16:07:33Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney Medicine |
| spelling | doaj.art-d105c973b8da4721b4631af7dfad3ba92023-02-10T04:23:16ZengElsevierKidney Medicine2590-05952023-02-0152100584Serum Phosphorus Level Rises in US Hemodialysis Patients Over the Past Decade: A DOPPS Special ReportMurilo Guedes0Brian Bieber1Indranil Dasgupta2Almudena Vega3Kosaku Nitta4Steven Brunelli5John Hartman6Jochen G. Raimann7Bruce M. Robinson8Ronald L. Pisoni9Pontificia Universidade Católica do Paraná, Curitiba, Paraná, Brazil; Arbor Research Collaborative for Health, Ann Arbor, Michigan; Address for Correspondence: Murilo Guedes, R. Imaculada Conceicao, Curitiba, PR, Brazil 80215-901.Arbor Research Collaborative for Health, Ann Arbor, MichiganUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry, UKLa Fundacion para la Investigacion Biomedica del Hospital Gregorio Maranon, Madrid, Comunidad de Madrid, SpainDepartment of Nephrology, Tokyo Women’s Medical University, Tokyo, JapanDaVita Clinical Research, Minneapolis, MinnesotaVisonex, Green Bay, WisconsinRenal Research Institute, New York, New YorkArbor Research Collaborative for Health, Ann Arbor, MichiganArbor Research Collaborative for Health, Ann Arbor, MichiganMineral bone disorder (MBD) is a frequent consequence of chronic kidney disease, more so in patients with kidney failure treated by kidney replacement therapy. Despite the wide availability of interventions to control serum phosphate and parathyroid hormone levels, unmet gaps remain on optimal targets and best practices, leading to international practice pattern variations over time. In this Special Report, we describe international trends from the Dialysis Outcomes and Practice Patterns Study (DOPPS) for MBD biomarkers and treatments from 2002-2021, including data from a group of 7 European countries (Belgium, France, Germany, Italy, Spain, Sweden, United Kingdom), Japan, and the United States. From 2002-2012, mean phosphate levels declined in Japan (5.6 to 5.2 mg/dL), Europe (5.5 to 4.9 mg/dL), and the United States (5.7 to 5.0 mg/dL). Since then, levels rose in the United States (to mean 5.6 mg/dL, 2021), were stable in Japan (5.3 mg/dL), and declined in Europe (4.8 mg/dL). In 2021, 52% (United States), 27% (Europe), and 39% (Japan) had phosphate >5.5 mg/dL. In the United States, overall phosphate binder use was stable (80%-84% over 2015-2021), and parathyroid hormone levels rose only modestly. Although these results potentially stem from pervasive knowledge gaps in clinical practice, the noteworthy steady increase in serum phosphate in the United States over the past decades may be consequential to patient outcomes, an uncertainty that hopefully will soon be addressed by ongoing clinical trials. The DOPPS will continue to monitor international trends as new interventions and strategies ensue for MBD management in chronic kidney disease.http://www.sciencedirect.com/science/article/pii/S2590059522002175 |
| spellingShingle | Murilo Guedes Brian Bieber Indranil Dasgupta Almudena Vega Kosaku Nitta Steven Brunelli John Hartman Jochen G. Raimann Bruce M. Robinson Ronald L. Pisoni Serum Phosphorus Level Rises in US Hemodialysis Patients Over the Past Decade: A DOPPS Special Report Kidney Medicine |
| title | Serum Phosphorus Level Rises in US Hemodialysis Patients Over the Past Decade: A DOPPS Special Report |
| title_full | Serum Phosphorus Level Rises in US Hemodialysis Patients Over the Past Decade: A DOPPS Special Report |
| title_fullStr | Serum Phosphorus Level Rises in US Hemodialysis Patients Over the Past Decade: A DOPPS Special Report |
| title_full_unstemmed | Serum Phosphorus Level Rises in US Hemodialysis Patients Over the Past Decade: A DOPPS Special Report |
| title_short | Serum Phosphorus Level Rises in US Hemodialysis Patients Over the Past Decade: A DOPPS Special Report |
| title_sort | serum phosphorus level rises in us hemodialysis patients over the past decade a dopps special report |
| url | http://www.sciencedirect.com/science/article/pii/S2590059522002175 |
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