title: Achievement of NKF/K-DOQI recommended target values for bone and mineral metabolism in incident hemodialysis patients: results of the FARO-2 cohort.
abstract: BACKGROUND
  Mineral Bone Disorders (MBD) is prevalent in hemodialysis (HD) patients and associated with increased cardiovascular mortality. The FARO-2 study evaluated the achievement of the NKF/K-DOQI guidelines on recommended target values for serum calcium (Ca), phosphorous (P) and intact parathyroid hormone (PTH) levels on survival in incident HD patients.
  
  
  METHODS
  Data were collected by questionnaire from 568 incident HD patients followed prospectively over a 3-year period from 26 Italian dialysis units. The cumulative probability of time-to-death for CKD-MBD treatment characteristics was determined by the Kaplan-Meier curves.
  
  
  RESULTS
  Serum PTH levels (median values at 6 months vs. 36 months; 225 vs. 254 pg/ml), Ca (8.8 vs. 8.9 g/dl) and P (5.1 vs. 4.8 mg/dl) were not significantly different at 6 months versus follow-up. The majority of incident HD patients (60-70%) who were followed up for 36 months did not achieve the NKF/K-DOQI recommended target values. Survival rates were higher in patients on target for three parameters versus patients off target (survival at 24 months: at target 95.7% (95% CI: 84.0-98.9) versus not on target 71.1% (95% CI: 66.3-75.4, p < 0.01)). The 30.1% of patients on target for three MBD parameters at least once during the follow-up period had better survival rates compared to those not reaching these targets (survival at 24 months: at least once 88.0% (95% CI: 81.9-92.1); 67.7% (95% CI: 61.9-72.8, p < 0.01)).
  
  
  CONCLUSIONS
  Our findings indicate that incident HD patients who achieved target levels (for three MBD parameters) for at least one visit have a lower risk of mortality.
authors.affiliation: Renal Division, Department of Health Sciences, University of Milan, San Paolo Hospital, Milan, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Cozzolino
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
authors.forename: Diego
authors.initials: D
authors.lastname: Brancaccio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cannella
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Bolasco
authors.forename: Marina
authors.initials: M
authors.lastname: Di Luca
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Costanzo
authors.forename: Umberto di Luzio
authors.initials: Ud
authors.lastname: Paparatti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Festa
authors.forename: Giuliana
authors.initials: G
authors.lastname: Gualberti
authors.forename: Sandro
authors.initials: S
authors.lastname: Mazzaferro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001842:Bone and Bones / Q000378:metabolism* / Q000473:pathology; D002118:Calcium / Q000097:blood*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010758:Phosphorus / Q000097:blood*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D006435:Renal Dialysis; D011795:Surveys and Questionnaires; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; C470125:PTH protein, human; D010281:Parathyroid Hormone; D010758:Phosphorus; D002118:Calcium