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COSMOS: the dialysis scenario of CKD-MBD in Europe

José Luis Fernández-Martín1, Juan Jesus Carrero, Miha Benedik

  • 1Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación, REDinREN del ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Asturias, Spain.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|November 21, 2012
PubMed

Insights

Management of mineral and bone disorders in chronic kidney disease patients varies significantly across Europe. This study highlights key differences in treatment practices and patient characteristics among European hemodialysis populations.

Area of Science:

  • Nephrology
  • Endocrinology
  • Public Health

Background:

  • Chronic kidney disease-mineral and bone disorders (CKD-MBD) are significant complications in patients with end-stage renal disease (ESRD) on dialysis, contributing to increased mortality.
  • Understanding regional variations in CKD-MBD management is crucial for improving patient outcomes.

Purpose of the Study:

  • To describe the characteristics of the European hemodialysis population.
  • To analyze current practices in the prevention, diagnosis, and treatment of secondary hyperparathyroidism across different European regions.
  • To identify disparities in CKD-MBD management within Europe.

Main Methods:

  • The COSMOS study is a 3-year, multicenter, prospective, observational cohort study.
  • Data were collected from hemodialysis patients across 20 European countries between 2005 and 2007.
  • Analysis focused on patient demographics, CKD-MBD biochemical parameters, and treatment strategies.

Main Results:

  • The European hemodialysis population is elderly, with high rates of diabetes and cardiovascular disease.
  • Significant regional differences exist in the monitoring of CKD-MBD parameters (calcium, phosphorus, PTH) and achievement of treatment targets.
  • Variations in active vitamin D use and parathyroidectomy criteria were observed across European regions, with notable differences between Mediterranean and non-Mediterranean countries.

Conclusions:

  • Baseline results from the COSMOS study reveal substantial heterogeneity in CKD-MBD management across Europe.
  • These findings underscore the need for standardized approaches to CKD-MBD care to mitigate associated mortality risks.
Abstract

Keywords:
CKD–MBDPTHcalciumepidemiologyphosphorous

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