Effect of extended hours dialysis on markers of chronic kidney disease-mineral and bone disorder in the ACTIVE Dialysis study.

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dc.contributor.author Zhan, Zhipeng en
dc.contributor.author Smyth, Brendan en
dc.contributor.author Toussaint, Nigel D en
dc.contributor.author Gray, Nicholas A en
dc.contributor.author Zuo, Li en
dc.contributor.author de Zoysa, Janak en
dc.contributor.author Chan, Christopher T en
dc.contributor.author Jin, Chenggang en
dc.contributor.author Scaria, Anish en
dc.contributor.author Hawley, Carmel M en
dc.contributor.author Perkovic, Vlado en
dc.contributor.author Jardine, Meg J en
dc.contributor.author Zhang, Ling en
dc.date.accessioned 2020-01-13T00:00:51Z en
dc.date.issued 2019-07-12 en
dc.identifier.citation BMC nephrology 20(1):258 12 Jul 2019 en
dc.identifier.issn 1471-2369 en
dc.identifier.uri http://hdl.handle.net/2292/49651 en
dc.description.abstract BACKGROUND:Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) is a significant cause of morbidity among haemodialysis patients and is associated with pathological changes in phosphate, calcium and parathyroid hormone (PTH). In the ACTIVE Dialysis study, extended hours dialysis reduced serum phosphate but did not cause important changes in PTH or serum calcium. This secondary analysis aimed to determine if changes in associated therapies may have influenced these findings and to identify differences between patient subgroups. METHODS:The ACTIVE Dialysis study randomised 200 participants to extended hours haemodialysis (≥24 h/week) or conventional haemodialysis (≤18 h/week) for 12 months. Mean differences between treatment arms in serum phosphate, calcium and PTH; and among key subgroups (high vs. low baseline phosphate/PTH, region, time on dialysis, dialysis setting and frequency) were examined using mixed linear regression. RESULTS:Phosphate binder use was reduced with extended hours (- 0.83 tablets per day [95% CI -1.61, - 0.04; p = 0.04]), but no differences in type of phosphate binder, use of vitamin D, dose of cinacalcet or dialysate calcium were observed. In adjusted analysis, extended hours were associated with lower phosphate (- 0.219 mmol/L [- 0.314, - 0.124; P < 0.001]), higher calcium (0.046 mmol/L [0.007, 0.086; P = 0.021]) and no change in PTH (0.025 pmol/L [- 0.107, 0.157; P = 0.713]). The reduction in phosphate with extended hours was greater in those with higher baseline PTH and dialysing at home. CONCLUSION:Extended hours haemodialysis independently reduced serum phosphate levels with minimal change in serum calcium and PTH levels. With a few exceptions, these results were consistent across patient subgroups. TRIAL REGISTRATION:Clinicaltrials.gov NCT00649298 . Registered 1 April 2008. en
dc.format.medium Electronic en
dc.language eng en
dc.relation.ispartofseries BMC nephrology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.title Effect of extended hours dialysis on markers of chronic kidney disease-mineral and bone disorder in the ACTIVE Dialysis study. en
dc.type Journal Article en
dc.identifier.doi 10.1186/s12882-019-1438-3 en
pubs.issue 1 en
pubs.begin-page 258 en
pubs.volume 20 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 777534 en
dc.identifier.eissn 1471-2369 en
pubs.record-created-at-source-date 2019-07-14 en
pubs.dimensions-id 31299919 en

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https://creativecommons.org/licenses/by/4.0/ Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0/


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