Category Archives: Medications
Sevelamer Versus Calcium Carbonate in Incident Hemodialysis Patients: Results of an Open-Label 24-Month Randomized Clinical Trial
Hemodialysis.com eInterview with:
Dr. Antonio Bellasi
UOC Nefrologia e Dialisi
Azienda Ospedaliera S.Anna (CO), Via Ravona,
22020 San Fermo della Battaglia (Como), Italy
and Dr. Biagio Raffaele Di Iorio
Università degli Studi di Napoli Federico II
Hemodialysis.com: What are the main findings of the study?
Response: The main findings are that non-calcium containing phosphate binder maybe superior than calcium containing phosphate binder in CKD-5D dialysis patients. Current results expand the existing body of evidence, confirming what reported by Block et al in a secondary analysis of the RIND study (Block et al Kidney Int 2007; 71(5):438-41) and suggesting the survival benefit is mainly driven by the different impact of these 2 phosphate binder regimens on the cardiovascular system.
Indeed, we did not observe any non-CV survival difference between groups.
Finally, numerous studies suggest now that calcium supplementation maybe associated with a significant increase in the CV risk in post-menopausal women further questioning the excessive use of calcium (Bolland et al Br Med J 2010; 341:C3691).
Marie Benz, MD on Google+Evaluation of colestilan in chronic kidney disease dialysis patients with hyperphosphataemia and dyslipidaemia: a randomized, placebo-controlled, multiple fixed-dose tria
Hemodialysis.com eInterview with
Prof. Francesco Locatelli, MD, FRCP
Department of Nephrology and Dialysis, Ospedale A. Manzoni
Via Dell’Eremo 9–11
IT–23900 Lecco (Italy)
Written Interview conducted with author by Editor Marie Benz, MD
Hemodialysis.com: What are the main findings of the study?
Prof. Locatelli: This global 642 patient study assessed the effect of a range of doses of the new, non-metallic phosphate binder, colestilan, in reducing simultaneously both serum phosphorus and LDL-cholesterol levels in patients with chronic kidney disease stage 5 on dialysis who have both hyperphosphataemia and dyslipidaemia. In this 12 week, double-blind trial, which is probably the largest dual-endpoint study done in this area, we showed that colestilan significantly lowered both serum phosphorus and LDL-cholesterol, over a range of doses, while not influencing calcium levels and is generally well tolerated. Colestilan also was shown to reduce total cholesterol, oxidised LDL-cholesterol, high HbA1c levels and uric acid.
Lipoprotein Kinetics in Male Hemodialysis Patients Treated with Atorvastatin.
Hemodialysis.com eInterview with Prof. Hans Dieplinger PhD
Division of Genetic Epidemiology
Department of Medical Genetics, Clinical and Molecular Pharmacology
Innsbruck Medical University
Schöpfstrasse 41
A-6020 Innsbruck Austria
email hans.dieplinger@i-med.ac.at
Written Interview conducted with author by Editor Marie Benz, MD
Hemodialysis.com: What are the main findings of the study?
Dr. Dieplinger: Our study was based on previous investigations from our group on the kinetics of atherogenic lipoproteins in hemodialysis patients. These former studies revealed a metabolic disorder of diminished synthesis AND degradation of apoB-containing lipoproteins resulting in prolonged residence times in circulation of these lipoproteins despite of their concentrations in normal ranges. The aim of our recent study was therefore to test whether HMG-CoA-reductase inhibitors (statins) which are known to normalize impaired degradation of apoB-containing lipoproteins in hypercholesterolemic patients exert similar beneficial effects also in CKD patients treated with hemodialysis. The main findings in a small group of male hemodialysis patients were significant reductions of total and LDL cholesterol as well as improved kinetics (including residence times) of atherogenic lipoproteins.
Disease Progression and Surgical Parathyroidectomy in the EVOLVE Trial
Hemodialysis.com eInterview with:
Patrick Parfrey, MD, FRCPC, FACP on behalf of the EVOLVE investigators
University Research Professor at Memorial University
St. John’s, Newfoundland and a staff nephrologist.
Dr. Parfrey is Associate Dean for Clinical Research, Research Chief of Eastern Health
Hemodialysis.com: What are the main findings of the study?
Dr. Parfrey: The EVOLVE trail enrolled 3883 patients with secondary hyperparathyroidism from 22 countries , randomly allocated them to the calcimimetic, cinacalcet ,or placebo, and followed them for up to 64 months. Parathyroidectomy was undertaken in patients with severe unremitting hyperparathyroidism: PTH level prior to surgery 2143 mg/dl in the cinacalcet group and 1873 in the placebo group.
Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy – a meta-analysis of 11 randomized controlled trials involving 21,295 participants
Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy – a meta-analysis of 11 randomized controlled trials involving 21,295 participants
Prof. Maciej Banach, MD, FNLA, FAHA, FESC, FASA, FRSPH
President, Polish Lipid Association
http://www.polishlipidassociation.com
Editor-in-chief, Archives of Medical Science
http://www.ArchivesofMedicalScience.com
Head, Department of Hypertension
Chair of Nephrology and Hypertension
Medical University of Lodz, Poland
E-mail: maciej.banach@umed.lodz.pl
Hemodialysis.com: What are the main findings of the study?
Dr. Banach: The use of statins in subjects with non-dialysis-dependent chronic kidney disease (CKD) resulted in a marked (statistically significant) reduction in death from all causes, cardiac causes, cardiovascular events and stroke. The use of statins in dialysis-dependent CKD patients resulted in a non‑significant effect on death from all causes and stroke, but had the effect of reducing death from cardiac causes and cardiovascular events (however the last two data were obtained on the very limited studies).
Cost implications of switching from sevelamer to lanthanum carbonate within a bundled reimbursement scenario
Interview with Dr. Michael S Keith Shire Pharmaceuticals, Wayne, PA, USA
Hemodialysis.com: What are the main findings of the study?
Dr. Keith: The key finding from this post hoc analysis is that phosphate control was similar regardless of the prior sevelamer dose a patient received. Overall mean phosphate binder doses were SH 7703 mg/day and LC 2800 mg/day. Drug cost-savings were realized when applying clinically utilized doses of lanthanum carbonate (LC) 3000 mg/day ($26.46/day) and sevelamer hydrochloride (SH) from doses of 6400 mg/day ($29.68/day) and above. Cost savings were as high as $18/day when converting patients from SH 9600 mg/day to LC 3000 mg/day.
Cinacalcet –Troponins: Is There An Undiscovered Link??
Hemodialysis.com Interview with Samra Abouchacra
Senior consultant nephrologist and Chairman Nephrology Department
Tawam Hospital United Arab Emirates
Hemodialysis.com: What are the main findings of the study?
Answer: A possible link between Cinacalcet- induced reductions in PTH & troponin levels in hemodialysis patients.
Hemodialysis.com: Were any of the findings unexpected?
Answer: Not completely given the role of inflammation in both.
Hemodialysis.com: What should clinicians and patients take away from this study?
Answer: Treatment of SHPT in dialysis patients may have an impact on cardiac markers suggesting an association between hyperparathyroid dysfunction and ischemic heart disease; a relation which needs further study including the effects of confounding variables.
Hemodialysis.com: What recommendations do you have for future research as a result of your study?
Answer: PTH-dependent and independent effects may be at play in the increased cardiovascular risk in dialysis patients. This needs to be explored in addition to role of inflammation and the correlation with clinical outcomes.
Citation:
Cinacalcet –Troponins: Is There An Undiscovered Link??
Presented at Spring NKF 2013 Meeting.
Treatment of Anemia with Darbepoetin Alfa in Systolic Heart Failure
from Angina.com: In patients who have anemia with symptomatic heart failure, treatment with darbepoetin alfa to normalize hemoglobin does not end up reducing morbidity or mortality. Findings suggest that hemoglobin is a marker of poor prognosis in heart failure, rather than a therapeutic target.
