• Diego Brancaccio, Mario Cozzolino, Giuseppe Cannella, Piergiorgio Messa, Mario Bonomini, Giovanni Cancarini, Maria Rosa Caruso, Carmelo Cascone, Anna Maria Costanzo, Umberto di Luzio Paparatti, Sandro Mazzaferro, and FARO Study Group.
• Nephrology Unit, University of Milan, Milan, Italy. diego.brancaccio@tiscalinet.it
• Blood Purif. 2011 Jan 1;32(2):124-32.

IntroductionVitamin D receptor activator (VDRA) therapy has been shown to be associated with reduced mortality rates in chronic kidney disease (CKD) patients with secondary hyperparathyroidism (SHPT). However, differences between VDRAs in their ability to reduce both all-cause and cardiovascular-related mortality rates are not yet fully elucidated.MethodsThe objective of the current analysis was to determine the effect of VDRA therapy on mortality in an Italian dialysis population, observed prospectively every 6 months for 18 months. Patients were investigated for all-cause and cardiovascular-related mortality risk adjusted for various demographic, clinical, and/or SHPT treatment variables.ResultsThe cumulative probabilities of all-cause and cardiovascular-related mortality were lower for patients who received any VDRA treatment compared with those who did not (p < 0.001) regardless of all measured variables. Additionally, patients who received paricalcitol and/or cinacalcet (with or without VDRAs) compared with calcitriol showed a significant improvement in both all-cause and cardiovascular-related mortality (p < 0.001). Cinacalcet with or without VDRAs was not associated with a further decrease of mortality hazard ratios compared with paricalcitol monotherapy.ConclusionsVDRA therapy (associated or not with cinacalcet) was associated with improved survival in dialysis patients, independent of demographic and clinical variables.Copyright © 2011 S. Karger AG, Basel.

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