<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0211-6995</journal-id>
<journal-title><![CDATA[Nefrología (Madrid)]]></journal-title>
<abbrev-journal-title><![CDATA[Nefrología (Madr.)]]></abbrev-journal-title>
<issn>0211-6995</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Nefrología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0211-69952016000200164</article-id>
<article-id pub-id-type="doi">10.1016/j.nefro.2015.10.006</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Anti-parathyroid treatment effectiveness and persistence in incident haemodialysis patients with secondary hyperparathyroidism]]></article-title>
<article-title xml:lang="es"><![CDATA[Efectividad y persistencia de los tratamientos del hiperparatiroidismo secundario en pacientes incidentes en hemodiálisis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martín de Francisco]]></surname>
<given-names><![CDATA[Angel Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gillespie]]></surname>
<given-names><![CDATA[Iain Andrew]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gioni]]></surname>
<given-names><![CDATA[Ioanna]]></given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Floege]]></surname>
<given-names><![CDATA[Jürgen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kronenberg]]></surname>
<given-names><![CDATA[Florian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marcelli]]></surname>
<given-names><![CDATA[Daniele]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Wheeler]]></surname>
<given-names><![CDATA[David Collins]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Froissart]]></surname>
<given-names><![CDATA[Marc]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Drueke]]></surname>
<given-names><![CDATA[Tilman Bernhard]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Cantabria Hospital Universitario Valdecilla Servicio de Nefrología]]></institution>
<addr-line><![CDATA[Santander ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Amgen Ltd Center for Observational Research (CfOR) ]]></institution>
<addr-line><![CDATA[Uxbridge ]]></addr-line>
<country>United Kingdom</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,RWTH University of Aachen Nephrology ]]></institution>
<addr-line><![CDATA[Aachen ]]></addr-line>
<country>Germany</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Medical University of Innsbruck Department of Medical Genetics, Molecular and Clinical Pharmacology Division of Genetic Epidemiology]]></institution>
<addr-line><![CDATA[Innsbruck ]]></addr-line>
<country>Austria</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Fresenius Medical Care EMEALA Medical Board ]]></institution>
<addr-line><![CDATA[Bad Homburg ]]></addr-line>
<country>Germany</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,University College London Division of Medicine Center for Nephrology]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>United Kingdom</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Amgen Europe GmbH International Development Nephrology ]]></institution>
<addr-line><![CDATA[Zug ]]></addr-line>
<country>Switzerland</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Université de Picardie UFR Médecine/Pharmacie Inserm U 1088]]></institution>
<addr-line><![CDATA[Amiens ]]></addr-line>
<country>France</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2016</year>
</pub-date>
<volume>36</volume>
<numero>2</numero>
<fpage>164</fpage>
<lpage>175</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0211-69952016000200164&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0211-69952016000200164&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0211-69952016000200164&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Anti-parathyroid treatment initiation and discontinuation are important decisions in chronic haemodialysis (HD) patients, where pill burden is often excessive. The present study aimed to describe secondary hyperparathyroidism (sHPT) drug therapy changes in HD patients.  Methods: Retrospective observational cohort study of incident European HD patients with sHPT who were prescribed calcitriol or alfacalcidol (alpha calcitriol), paricalcitol or cinacalcet.  Results: Treatment-naïve patients prescribed alpha calcitriol (N = 2259), paricalcitol (N = 1689) and cinacalcet (N = 1245) were considered for analysis. Serum intact parathyroid hormone (iPTH) levels decreased post-initiation with all treatment modalities; serum calcium and phosphate levels increased in response to activated vitamin D derivatives but decreased with cinacalcet. Approximately one-third of alpha calcitriol and paricalcitol patients but less than one-quarter of cinacalcet patients discontinued treatment. Although the three groups had comparable serum iPTH control at the time of treatment discontinuation, they differed in terms of calcium and phosphate levels. Following discontinuation, the evolution of laboratory parameters differed by treatment modality: whilst iPTH increased for all three treatment groups, calcium and phosphate decreased in patients who were being treated with alpha calcitriol and paricalcitol at the time of discontinuation, and increased in those who had been treated with cinacalcet.  Conclusions: In conditions of daily clinical practice, attaining and maintaining recommended biochemical control of sHPT appears to be more frequently achievable with cinacalcet than with activated vitamin D compounds.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: El inicio y la discontinuación del tratamiento antiparatiroideo son decisiones importantes en los pacientes en hemodiálisis crónica (HD) en los que la carga de pastillas es con frecuencia excesiva. El objetivo de este estudio es describir de tratamiento del hiperparatiroidismo secundario (sHPT) en pacientes en HD.  Métodos: Estudio de cohorte, observacional retrospectivo de pacientes europeos incidentes en HD con sHPT a quienes se prescribió calcitriol o alfacalcidol (calcitriol-alfa), paricalcitol o cinacalcet.  Resultados: Se incluyeron en el análisis pacientes que recibieron por primera vez calcitriol-alfa (N = 2259), paricalcitol (N = 1689) y cinacalcet (N = 1245). Los valores sericos de hormona paratiroidea intacta (iPTH) disminuyeron tras iniciación con todos los tratamientos; los valores de calcio y fosforo serico se elevaron en respuesta al tratamiento con activadores de vitamina D pero disminuyeron con cinacalcet. Aproximadamente un tercio de los pacientes que recibieron calcitriol alfa y paricalcitol, y menos de una cuarta parte de los de cinacalcet discontinuaron el tratamiento. Aunque los tres grupos tuvieron descensos comparables de iPTH al momento de la interrupción del tratamiento, sin embargo difirieron en los valores de calcio y fosforo serico. Tras la interrupción, la evolución de los parámetros de laboratorio fué diferente según la modalidad de tratamiento: mientras que la iPTH se elevó en las tres modalidades, el calcio y fosforo sericos disminuyeron en los pacientes que estaban siendo tratados con calcitriol-alfa y paricalcitol en el momento de la interrupción y aumentaron en los que lo hacían con cinacalcet.  Conclusiones: En condiciones clínicas que representan la practica diaria, alcanzar y mantener los valores recomendados para el control del sHPT se consigue más frecuentemente con cinacalcet que con compuestos activos de vitamina D.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Chronic kidney disease]]></kwd>
<kwd lng="en"><![CDATA[Chronic kidney disease-mineral and bone disorder]]></kwd>
<kwd lng="en"><![CDATA[Haemodialysis]]></kwd>
<kwd lng="en"><![CDATA[Secondary hyperparathyroidism]]></kwd>
<kwd lng="en"><![CDATA[Treatment initiation]]></kwd>
<kwd lng="en"><![CDATA[Treatment persistence]]></kwd>
<kwd lng="en"><![CDATA[Treatment discontinuation]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad renal crónica]]></kwd>
<kwd lng="es"><![CDATA[Alteraciones del metabolismo oseo-mineral en la enfermedad renal crónica]]></kwd>
<kwd lng="es"><![CDATA[Hemodiálisis]]></kwd>
<kwd lng="es"><![CDATA[Hiperparatiroidismo secundario]]></kwd>
<kwd lng="es"><![CDATA[Inicio del tratamiento]]></kwd>
<kwd lng="es"><![CDATA[Mantenimiento del tratamiento]]></kwd>
<kwd lng="es"><![CDATA[Interrupción del tratamiento]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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