IMPORTANCE Secondary hyperparathyroidism contributes to extraskeletal complications in chronic kidney disease.OBJECTIVE To evaluate the effect of the intravenous calcimimetic etelcalcetide on serum parathyroid hormone (PTH) concentrations in patients receiving hemodialysis.DESIGN, SETTING, AND PARTICIPANTS Two parallel, phase 3, randomized, placebo-controlled treatment trials were conducted in 1023 patients receiving hemodialysis with moderate to severe secondary hyperparathyroidism. Trial A was conducted in 508 patients at 111 sites in the
Abstract. Long-term kidney allograft survival continues to remain an elusive goal. Kidney transplant recipients are believed to be at high risk for loss of allograft function, and new, potentially non-nephrotoxic immunosuppressive medications are advocated to improve long-term allograft survival. To evaluate the efficacy of such therapeutic interventions, information regarding the change in GFR among kidney transplant recipients with long-term allograft survival is needed. We studied 40,963 transplant recipients between 1987 and 1996 with allograft survival of at least 2 yr in the United States Renal Data System. Linear regression methods were applied to serial GFR estimates after transplantation. The baseline mean GFR at 6 mo after transplantation was 49.6 Ϯ 15.4 ml/min per 1.73 m 2 .During the mean follow-up of 5.7 Ϯ 2.3 yr, the mean Ϯ standard error of the change in GFR was Ϫ1.66 Ϯ 6.51 ml/min per 1.73 m 2 per year (median, Ϫ0.94 L/min per 1.73 m 2 per year). A total of 12,583 (
Tacrolimus and MMF were the calcineurin inhibitor and purine metabolism inhibitor associated with the most favorable effects on rates of change in allograft function. Because most transplant recipients establish a low baseline level of allograft function, the effect of immunosuppression medication on GFR decline should be considered when selecting a maintenance immunosuppression regimen.
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