Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HIMSS 2023
  • Opinion
    • Breaking Bias
    • Commentaries
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - AI and Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Patient Care
Sponsored Content Provided By UNIVANTS of Healthcare Excellence
This content was created by and paid for by an advertiser. The Crain's editorial department was not involved in the creation of this content.
October 17, 2022 12:00 AM

Renal Osteodystrophy Monitoring by Monthly Parathyroid Hormone Determination in Hemodialysis Chronic Kidney Disease-Mineral Bone Disorder Patients

University Hospital Centre Zagreb | Zagreb, Croatia

  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Zagreb team photo

    A major complication of end stage renal disease (ESRD) is renal osteodystrophy or chronic kidney disease mineral bone disorder (CKD- MBD), which leads to both skeletal and extraskeletal complications. Although not preventable in dialysis patients, monitoring and appropriate management may at least relieve the symptoms and pain that patients experience.

    Management of CKD-MBD requires careful and consistent control of phosphate, calcium (calcimimetics), vitamin D and parathyroid hormone (PTH), which at excessive levels causes inadequate bone mineralization (i.e. inadequate strengthening of bones) and increased mineral resorption (i.e. the process of breaking down bones). Thus, monitoring the concentration of each of these treatments is essential to ensure therapeutic optimization. This is equally important as the only known resolution to CKM-MBD is a renal transplant, which can often take significant time to secure a match. Fortunately, careful monitoring and management can minimize the symptoms of bone pain and frequency of fractures.

    Global guidelines recommend monitoring bone biomarkers in this patient population every 3 to 6 months, with biomarkers including alkaline phosphatase and PTH. However, more frequent monitoring in patients receiving treatment for CKD- MBD, or in those with CKD and known biochemical abnormalities, offers the potential to identify biomarker trends and perform early assessment of treatment efficacy – ultimately mitigating many associated side effects.

    Given that CKD-MBD is a major cause of morbidity and mortality in patients undergoing dialysis, the University Hospital Centre Zagreb and Polyclinic Avitum in Zagreb, Croatia, developed and implemented a best practice for frequent monitoring of bone biomarkers in these patients. Per the protocol, patients on calcimimetics and Vitamin D or its analogs undergo biomarker monitoring every 4 to 5 weeks. Children undergoing dialysis who develop CKD-MBD additionally undergo monthly PTH monitoring. This approach of more frequent monitoring enabled better titration of drug dosing, leading to preserve bone density, while avoiding other potential side effects.

    The care team’s monthly monitoring also changed the patient experience for the better, with 100% of patients expressing enhanced satisfaction with their level of care, reporting that they felt healthier, happier and less stressed with regularly scheduled checkups. Patients understood that regularly scheduled monitoring permitted therapeutic changes, and several commented on the benefits of this approach.

    One patient noted, “In communication with my physician, my therapy was adjusted for better clinical results. Upon changes to my regimen, I am feeling much better.” Another said, “I had been previously consuming 15 pills daily. Upon therapeutic change, the number of pills decreased. I am more satisfied because it is easier to follow up on my therapy schedule and consume fewer pills.”

    There was also demonstrated benefit to clinicians, who reported that the initiative reduced clinical uncertainty, provided higher confidence for decision-making and enhanced clinical satisfaction. Ninety-eight percent of nephrologists involved indicated they felt more secure managing dialysis patients with the increased frequency of PTH checks, which enabled dosage adjustments based on laboratory findings.

    “More frequent monitoring of PTH contributes to better calcimimetic and vitamin D analogs titration, slowing the development of secondary hyperparathyroidism, and helps with prevention of calcium bone loss,” said Ninoslav Leko, head of Nephrology for Slavonski Brod General Hospital. “This makes us more confident in providing better and more accurate therapy.”

    Kresimir Grsic, PhD, a surgeon at University Hospital Centre Zagreb, elaborated on the profound impact to clinician satisfaction due to improved patient experience.

    “Thanks to more frequent PTH testing, we achieved better PTH control and have noticed a decreased number of hyperparathyroid patients who needed parathyroid gland surgical removal,” Dr. Grsic said.

    Importantly, the practice implemented by University Hospital Centre Zagreb yielded a 61% decrease in the annual cost of care due to reduced need for dialysis and bone-saving therapies.

    The changes to patients’ care have not gone unnoticed. Boris Kduumija, CEO of B. Braun Avitum Clinic Zagreb remarked: “Patients recognize the value of different and better management. Our data confirmed an associated increase in interest and applications for our institutional care and program,” he commented. “More frequent PTH testing enabled better results and therapy control. Physicians and patients were both more satisfied, creating overall value of our health system.”

    The development and initiation of this best practice succeeded in enhancing patient experience and mitigating long-term risk, with the added benefit of reducing overall healthcare costs. Given the achievement of positively impacting patient care and outcomes, this integrated clinical care team was awarded recognition of Achievement by the UNIVANTS of Healthcare Excellence award program.


    Download the PDF





       

     

    Sponsored by

    univants logo

    Apply by Nov. 15 to be considered for the 2022 UNIVANTS of Healthcare Excellence awards. For details, visit UnivantsHCE.com

    Most Popular
    1
    Centene to lay off 2,000 workers
    2
    How health systems are battling price-gouging allegations
    3
    Senate advances bill to temporarily aid hospitals, health centers
    4
    Elevance, Blue Cross Louisiana halt $2.5B proposed deal
    5
    Tower Health to sell urgent care centers, close others
    Sponsored Content
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HIMSS 2023
    • Opinion
      • Breaking Bias
      • Commentaries
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing