CIN '2007 - 4o CONGRESSO DE NEFROLOGIA NA INTERNET
Secondary hiperparathyroidism (SHPT) in hemodialysis: difficulty in the application of K/DOQI clinical practice guidelines in real patients and use of cinacalcet in severe hpts resistent to conventional treatment
Dra Mª Dolores Arenas Jiménez, Dra Mº Teresa Gil González, Dra Tamara Malek Marín, Dra Analía Moledous y Dr Fernando Alvarez-Ude
Hospital Perpetuo Socorro.Alicante.
Abstract
Nearly 50% of dialysis patients are reported to die from cardiovascular (CV) events and, over the last decade, there has been a 7% increase in admission rates for patients with CV disease. i Mineral metabolism has emerged as an important predictor of general and cardiovascular morbidity and mortality in dialysis patients. ii iii Severe SHPT, hyperphosphatemia, and total body calcium overload have been implicated in the pathophysiology of skeletal and extraskeletal calcifications and associated with increased morbidity and mortality among the dialysis population iv In order to provide a clinical action plan for an easier management of this complex problem, the K/DOQI Clinical Practice Guidelines for Bone Metabolism and Disease in Chronic Renal Disease were published in October 2003 v, but assessment of the results obtained from the application of those guidelines is essential for evaluating their true applicability and the consequences of its application. A previous study vi, carried out before calcimimetics were available in Spain, and based on monitoring of quality indicators following the publication of the K/DOQI Guidelines, showed that in spite of the application of K/DOQI recommendations, a large proportion of our patients remained outside the proposed targets and pointed to the need for more effective therapeutic options.Comments: