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001-es BibID:	BIBFORM040479
035-os BibID:	PMID:21148030
Első szerző:	Raggi, Paolo
Cím:	The ADVANCE study : a randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis / Paolo Raggi, Glenn M. Chertow, Pablo Urena Torres, Botond Csiky, Agostino Naso, Kaldun Nossuli, Moustafa Moustafa, William G. Goodman, Nicole Lopez, Gerry Downey, Bastian Dehmel, Jürgen Floege, the ADVANCE Study Group
Dátum:	2011
ISSN:	0931-0509
Megjegyzések:	This prospective, randomized, controlled trial compared the progression of vascular and cardiac valve calcification in 360 prevalent adult hemodialysis patients with secondary hyperparathyroidism treated with either cinacalcet plus low-dose vitamin D sterols or flexible doses of vitamin D sterols alone. METHODS: Eligible subjects were on hemodialysis for 3 months with parathyroid hormone (PTH) > 300 pg/mL or PTH 150-300 pg/mL with calcium-phosphorus product > 50 mg(2)/dL(2) while receiving vitamin D. All subjects received calcium-based phosphate binders. Coronary artery calcification (CAC) and aorta and cardiac valve calcium scores were determined both by Agatston and volume scoring using multi-detector computed tomography. Subjects with Agatston CAC scores 30 were randomized to cinacalcet (30- 180 mg/day) plus low-dose calcitriol or vitamin D analog (2 g paricalcitol equivalent/dialysis), or flexible vitamin D therapy. The primary end point was percentage change in Agatston CAC score from baseline to Week 52. RESULTS: Median (P10, P90) Agatston CAC scores increased 24% (-22%, 119%) in the cinacalcet group and 31% (-9%, 179%) in the flexible vitamin D group (P = 0.073). Corresponding changes in volume CAC scores were 22% (-12%, 105%) and 30% (-6%, 133%; P = 0.009). Increases in calcification scores were consistently less in the aorta, aortic valve and mitral valve among subjects treated with cinacalcet plus low-dose vitamin D sterols, and the differences between groups were significant at the aortic valve. CONCLUSIONS: In hemodialysis patients with moderate to severe secondary hyperparathyroidism, cinacalcet plus low-dose vitamin D sterols may attenuate vascular and cardiac valve calcification. Comment in An advance in preventing calcification in patients with dialysis-related hyperparathyroidism.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban calcification cinacalcet hemodialysis secondary hyperparathyroidism vitamin D külföldön készült közlemény
Megjelenés:	Nephrology Dialysis Transplantation. - 26 : 4 (2011), p. 1327-1339. -
További szerzők:	Chertow, Glenn M. Torres, Pablo Urena Csiky Botond Naso, Agostino Nossuli, Kaldun Moustafa, Moustafa Goodman, William G. Lopez, Nicole Downey, Gerry Dehmel, Bastian Floege, Jürgen Balla József (1959-) (belgyógyász, nephrológus) The ADVANCE Study Group
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