Table 3.
Temporal changes in clinical parameters and CKD-MBD medication use in patients with HD vintage ≤3 months (N = 286)
| Parameter | Baseline | Follow-up | p value | |||
|---|---|---|---|---|---|---|
| –1Q; ref | Q1 | Q2 | Q3 | Q4 | ||
| CKD-MBD biochemical markers | ||||||
| sP, mg/dL | 5.84 (0.07) | 5.56 (0.07)*** | 5.56 (0.07)*** | 5.51 (0.07)*** | 5.61 (0.07)** | <0.0001 |
| sP ≤5.5, mg/dL | 36.4 | 53.1*** | 56.8*** | 57.2*** | 55.1*** | <0.0001 |
| sP ≤4.5, mg/dL | 6.6 | 22.0*** | 21.1*** | 21.8*** | 19.3*** | <0.0001 |
| Serum calcium, mg/dL | 8.75 (0.03) | 8.96 (0.03)*** | 8.95 (0.03)*** | 8.96 (0.03)*** | 8.92 (0.03)*** | <0.0001 |
| iPTH, pg/mL | 554 (20) | 476 (19)*** | 459 (19)*** | 448 (19)*** | 452 (19)*** | <0.0001 |
| CKD-MBD medications | ||||||
| PB pills/day | 0 | 3.7 (0.09) | 4.0 (0.09) | 4.3 (0.09) | 4.4 (0.09) | NA |
| Cinacalcet use | 5.2 | 11.2** | 15.4*** | 17.1*** | 17.8*** | <0.0001 |
| Home cinacalcet dose, mg/day | 22.6 (4.8) | 34.2 (3.5)* | 36.2 (3.3)* | 41.0 (3.3)*** | 44.7 (3.2)*** | <0.0001 |
| In-center cinacalcet dose, mg/administration | 11.5 (7.3) | 19.9 (4.5) | 30.6 (4.1)* | 50.9 (4.0)*** | 64.5 (3.9)*** | <0.0001 |
| Etelcalcetide use | 0 | 0.3 | 2.1 | 2.8 | 3.5 | <0.0001 |
| Total vitamin D use | 57.7 | 71.3*** | 74.1*** | 76.9*** | 82.9*** | <0.0001 |
| Oral active vitamin D usea | 49.0 | 58.7** | 59.8*** | 59.4** | 65.0*** | <0.0001 |
| IV active vitamin D useb | 9.8 | 14.7** | 16.8*** | 18.5*** | 19.2*** | <0.0001 |
| Nutritional and clearance parameters | ||||||
| Serum albumin, g/dL | 3.58 (0.02) | 3.77 (0.02)*** | 3.84 (0.02)*** | 3.87 (0.02)*** | 3.87 (0.02)*** | <0.0001 |
| Predialysis weight, kg | 90.4 (1.5) | 90.3 (1.5) | 90.9 (1.5)*** | 91.4 (1.5)*** | 91.9 (1.5)*** | <0.0001 |
| enPCR, g/kg/day | 0.83 (0.01) | 0.91 (0.01)*** | 0.93 (0.01)*** | 0.92 (0.01)*** | 0.93 (0.01)*** | <0.0001 |
| eKt/V | 1.41 (0.02) | 1.44 (0.02) | 1.45 (0.02) | 1.44 (0.02) | 1.46 (0.02)* | 0.22 |
Values are presented as least-squares mean (standard error) or %. p values compare summary estimates across time with -Q1 as the reference. Overall p values were calculated using linear mixed-effects regression (continuous variables) or Cochran’s Q test (categorical variables).
CKD-MBD, chronic kidney disease-mineral and bone disorder; eKt/V, equilibrated Kt/V; enPCR, equilibrated normalized protein catabolic rate; HD, hemodialysis; iPTH, intact parathyroid hormone; IV, intravenous; NA, not applicable; PB, phosphate binder; sP, serum phosphorus.
*p < 0.05; **p < 0.001; ***p < 0.0001 (vs. baseline).
aIncludes calcitriol and doxercalciferol.
bIncludes doxercalciferol, calcitriol, and paricalcitol.