Prescrição de quelantes de fósforo e calcitriol para pacientes em hemodiálise crônica

Martins, Maria Tereza Silveira; Silva, Luciana Ferreira da; Martins, Márcia; Matos, Cácia Mendes; Melo, Nelson Almeida D'ávila; Azevedo, Matheus Freitas Cardoso de; Travessa, Iane Érica M.; Amoedo, Maurício Kauark; Fernandes, Pedro Amoedo; Nogueira, Fernanda Conceição Pereira; Lopes, Gildete Barreto

doi:10.1590/s0104-42302009000100019

Cited by 6 publications

(4 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly a study from Brazil also reported a large percentage of prescriptions of sevelamer among patients on maintenance hemodialysis despite the high cost of the medication and absence of contraindications for PB with calcium salts. [22] Though calcium salts are inexpensive, they are associated with increased risk of metastatic calcification. Sevelamer hydrochloride is an ion exchange resin, nonabsorbable, and the first PB that is not a source of aluminium or calcium.…”

Section: Discussionmentioning

confidence: 99%

Prescribing pattern of medicines in chronic kidney disease with emphasis on phosphate binders

et al. 2014

View full text Add to dashboard Cite

Objectives:Patients with chronic kidney disease (CKD) suffer with multiple comorbidities and complications like secondary hyperparathyroidism and hyperphosphotemia. Altered mineral metabolism contributes to bone disease and cardiovascular disease. In patients of CKD, despite dietary phosphorus restriction, phosphate binders (PBs) are recommended to control phosphorous level. No studies about the utilization pattern of PBs in CKD patients have been reported from India. This study analyses the current prescribing trends in the management of CKD patients undergoing tertiary care with focus on PBs.Materials and Methods:This cross-sectional, observational study was conducted in nephrology department of a government super speciality hospital over 8-month period from January to August 2011. Demographic, clinical, and medication details were collected in a specially designed proforma.Results:A total 111 prescriptions were included in the study. Average number of drugs per prescription was 9.47. About 41.53% of the prescribed drugs were from the World Health Organization essential medicines list. Out of total prescribed drugs (1052), most commonly prescribed were vitamins and minerals (24.71%), cardiovascular drugs, (22.14%), and hematopoietic agents (20.15%). Considering individual drugs, five most commonly prescribed drugs were multivitamins (14.82%), iron (8.65%), folic acid (8.55%), calcium carbonate (8.17%), and calcitriol (5.60%). A total of 11.02% of prescribed drug were PBs. Among PBs, calcium carbonate was the most frequently prescribed and sevelamer was the least prescribed PB. No patient was prescribed lanthanum carbonate.Conclusion:This study identified a wide variety of drug classes including PBs prescribed in CKD patients. Although sevelamer hydrochloride has less side effects as compared to calcium salts, it was less prescribed since it is costlier.

show abstract

Section: Discussionmentioning

confidence: 99%

Prescribing pattern of medicines in chronic kidney disease with emphasis on phosphate binders

et al. 2014

View full text Add to dashboard Cite

show abstract

“…The PROHEMO is an ongoing prospective cohort study of adult hemodialysis patients receiving treatment at four satellite dialysis units in the city of Salvador, BA, Brazil [17]. The Institutional Review Board of the Medical School of the Federal University of Bahia approved the study protocol, and all of the patients provided informed consent to participate.…”

Section: Methodsmentioning

confidence: 99%

Potentially modifiable factors associated with non-adherence to phosphate binder use in patients on hemodialysis

et al. 2013

Self Cite

View full text Add to dashboard Cite

BackgroundDespite the evidence that phosphate binder (PB) is associated with improved outcomes many hemodialysis patients do not adhere to prescribed PB regimen. Therefore, barriers to PB adherence should be identified and eliminated. The purpose of this study was to evaluate PB adherence among hemodialysis patients and to explore potentially modifiable factors associated with low PB adherence.MethodsA cross-sectional study (502 patients) was performed in four dialysis units in Salvador, Brazil, using data from the second phase of the Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO). Patients were categorized as adherent or non-adherent to PB based on their responses to a semi-structured questionnaire.ResultsNon-adherence to PB was observed for 65.7% of the patients. After adjustments for numerous covariates, cerebrovascular disease (odds ratio (OR), 3.30; 95% confidence interval (CI), 1.03-10.61), higher PTH (OR per each 300 pg/mL, 1.14; 95% CI, 1.01-1.28), lack of comprehension of the appropriate time to use PB (OR, 7.09; 95% CI, 2.10-23.95) and stopping PB use after feeling better (OR, 4.54; 95% CI, 1.45-14.25) or feeling worse (OR, 11.04; 95% CI, 1.79- 68.03) were significantly associated with PB non-adherence. By contrast, the adjusted odds of PB non-adherence were lower for patients with more years on dialysis (OR by each 2 years, 0.87; 95% CI, 0.80-0.95), with serum phosphorus above 5.5 mg/dL (OR, 0.53; 95% CI 0.34-0.82), who referred that were encouraged by the dialysis staff to be independent (OR, 0.52; 95% CI 0.30-0.90), and reported that the nephrologist explained how PB should be used (OR, 0.20; 95% CI 0.05-0.73).ConclusionThe results of the present study are encouraging by showing evidence that improvement in the care provided by the dialysis staff and the attending nephrologist may play an important role in reducing the high prevalence of non-adherence to PB in maintenance hemodialysis patients. A new questionnaire is presented and may help to evaluate systematically the patients regarding PB adherence in hemodialysis setting.

show abstract

“…A utilização de análogos de vitamina D é recomendada pela K/DOQI e, entre os pacientes da coorte, 8,0% faziam uso do calcitriol em qualquer dosagem. 11 No Brasil, o estudo de Martins et al 16 avaliou o uso destes medicamentos em 747 pacientes em hemodiálise em Salvador (Bahia), no qual, 31,9% dos pacientes faziam uso do calcitriol em qualquer dosagem. O achado do presente estudo diverge daquele previamente descrito, sendo estes os únicos estudos que descrevem a utilização desta substância no país até o momento.…”

Section: Discussionunclassified

“…11 Estudos demonstram uma associação de maiores níveis de 25-hidroxivitamina D com melhores estimativas de sobrevida em pacientes portadores de doença renal crônica, submetidos ou não a tratamento dialítico. 15 Em 2009, Martins et al 16 conduziram um estudo com o objetivo de avaliar a frequência de prescrição destes medicamentos em pacientes em hemodiálise no estado da Bahia, sendo este o único estudo encontrado até o momento descrevendo este aspecto da doença no Brasil.…”

unclassified

Overview of hemodialysis treatment funded by the Brazilian Unified Health System - An economic perspective

Menezes¹,

Barreto²,

Abreu³

et al. 2015

Jornal Brasileiro De Nefrologia

View full text Add to dashboard Cite

show abstract

Prescrição de quelantes de fósforo e calcitriol para pacientes em hemodiálise crônica

Cited by 6 publications

References 3 publications

Prescribing pattern of medicines in chronic kidney disease with emphasis on phosphate binders

Prescribing pattern of medicines in chronic kidney disease with emphasis on phosphate binders

Potentially modifiable factors associated with non-adherence to phosphate binder use in patients on hemodialysis

Overview of hemodialysis treatment funded by the Brazilian Unified Health System - An economic perspective

Contact Info

Product

Resources

About