title: Current management of secondary hyperparathyroidism: a multicenter observational study (COSMOS).
abstract: OBJECTIVE
  To survey bone mineral disturbances in the hemodialysis (HD) population in Europe and current clinical practice in Europe for the prevention, diagnosis and treatment of secondary hyperparathyroidism (SHPT) in HD patients.
  
  
  OBJECTIVE
  First, to estimate the prevalence of Kidney Disease Outcomes Quality Initiative (K/DOQI) guideline achievement in a representative sample of European hemodialysis subjects. As part of this objective, we will investigate the prevalence of achievement by type of dialysis, type of center and time on dialysis (less than or greater than 1 year). Among new dialysis subjects (less than 1 year), we will evaluate prevalence of K/DOQI target achievement until the end of the study. The study will run for 3 years. Second, to estimate the association of bone mineral markers (parathyroid hormone [PTH], calcium [Ca], serum phosphorus [P] and calcium phosphate product [CaxP]) classified by achievement of K/DOQI targets with mortality and overall cardiovascular hospitalization. Third, to characterize the longitudinal changes in bone mineral markers. As part of this objective, we will describe the patterns and predictors of bone mineral markers and achievement, with K/DOQI targets, using repeated measurements on individuals over time.
  
  
  OBJECTIVE
  First, To estimate the association of bone mineral markers (PTH, Ca, P and CaxP) classified by achievement of K/DOQI targets with specific cardiovascular outcomes, parathyroidectomy, manifest bone disease (including incidence of symptomatic bone fractures), hospitalizations and vascular access. Second, to evaluate the additional value of albumin and hemoglobin levels in conjunction with bone mineral markers in the prediction of mortality and clinical events.
authors.affiliation: Servicio de Metabolismo Oseo y Mineral, Instituto Reina Sofía de Investigación, Hospital Universitario Central de Asturias, Oveido, Spain. cannata@hca.es
authors.forename: Jorge B
authors.initials: JB
authors.lastname: Cannata-Andía
authors.forename: José Luis
authors.initials: JL
authors.lastname: Fernández-Martín
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
authors.forename: Gérard M
authors.initials: GM
authors.lastname: London
authors.forename: Francesco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Markus
authors.initials: M
authors.lastname: Ketteler
authors.forename: Aníbal
authors.initials: A
authors.lastname: Ferreira
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.forename: Jürgen
authors.initials: J
authors.lastname: Floege
authors.forename: José Luis
authors.initials: JL
authors.lastname: Górriz
authors.forename: Boleslaw
authors.initials: B
authors.lastname: Rutkowski
authors.forename: Dimitrios E
authors.initials: DE
authors.lastname: Memmos
authors.forename: Dierik
authors.initials: D
authors.lastname: Verbeelen
authors.forename: Christian
authors.initials: C
authors.lastname: Tielemans
authors.forename: Vladimir
authors.initials: V
authors.lastname: Teplan
authors.forename: Willem Jan
authors.initials: WJ
authors.lastname: Bos
authors.forename: Judit
authors.initials: J
authors.lastname: Nagy
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kramar
authors.forename: David J A
authors.initials: DJ
authors.lastname: Goldsmith
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Martin
authors.forename: Rudolf P
authors.initials: RP
authors.lastname: Wüthrich
authors.forename: Drasko
authors.initials: D
authors.lastname: Pavlovic
authors.forename: Mihael
authors.initials: M
authors.lastname: Benedik
mesh_terms: D015415:Biomarkers / Q000032:analysis; D015519:Bone Density; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D007674:Kidney Diseases / Q000150:complications; D015337:Multicenter Studies as Topic / Q000379:methods; D019370:Observation; D006435:Renal Dialysis / Q000009:adverse effects; D012107:Research Design
chemical_list: D015415:Biomarkers