Trends and consequences of mineral bone disorder in haemodialysis patients: lessons from The Dialysis Outcomes and Practice Patterns Study (DOPPS).

The Dialysis Outcomes and Practice Patterns Study (DOPPS), an ongoing observational study of haemodialysis (HD) patients, practices and outcomes in 12 countries, provides detailed data on chronic kidney disease-mineral bone disorder and related outcomes. This paper describes international trends in serum phosphorus, calcium and parathyroid hormone (PTH) levels over the past 10 years and reviews DOPPS findings on the relationship between mortality (all-cause and cardiovascular) and levels of serum phosphorus, calcium, PTH and alkaline phosphatase (AP). In addition, the DOPPS has shown how abnormal levels of these mineral metabolism indicators are associated with increased risk of certain clinical outcomes, including parathyroidectomies, fractures and pruritus.