Understanding the Korean Dialysis Cohort for Mineral, Vascular Calcification, and Fracture (ORCHESTRA) Study: Design, Method, and Baseline Characteristics

Abstract Introduction: End-stage renal disease (ESRD) is a growing disease worldwide, including Korea. This is an important condition that affects patient outcome. To provide optimal management for mineral disturbance, vascular calcification, and bone disease in ESRD patients, the Korean dialysis co...

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Published in:Kidney & blood pressure research 2024-01, Vol.49 (1), p.326-335
Main Authors: Ahn, Shin Young, Ko, Gang Jee, Hwang, Hyeon Seok, Jeong, Kyung Hwan, Jin, Kyubok, Kim, Yang Gyun, Moon, Ju-Young, Lee, Sang Ho, Lee, So-Young, Yang, Dong-Ho, Jung, Ji Yong, Oh, Kook-Hwan, Lee, Young-Ki, Kim, Gheun-Ho, Kim, Soo Wan, Kim, Yeong Hoon, Lee, Dong-Young, Hong, Yu Ah, Park, Hyeong Cheon, Yoon, Sun Ae, Choi, Bum Soon, Ban, Tae Hyun, Kim, Hyo Jin, Kwon, Young Joo
Format: Article
Language:English
Subjects:
Aged
Blood pressure
Bone Density
Calcification
Calcification (ectopic)
Cardiovascular disease
Cerebrovascular disease
Cholesterol
Cohort analysis
Cohort Studies
Consent
Data collection
Diabetes
Dialysis
Female
Fractures
Health services
Hemodialysis
Hospitalization
Hospitals
Humans
Kidney diseases
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - therapy
Male
Medical prognosis
Medical records
Middle Aged
Patients
Peritoneal dialysis
Prospective Studies
Renal Dialysis - adverse effects
Republic of Korea - epidemiology
Research Article
Thyroid gland
Vascular Calcification
Vein & artery diseases
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Summary:Abstract Introduction: End-stage renal disease (ESRD) is a growing disease worldwide, including Korea. This is an important condition that affects patient outcome. To provide optimal management for mineral disturbance, vascular calcification, and bone disease in ESRD patients, the Korean dialysis cohort for mineral, vascular calcification, and fracture (ORCHESTRA) study was conducted by enrolling Korean dialysis patients. Methods: Sixteen university-affiliated hospitals and one Veterans’ Health Service Medical Center participated in this study. This prospective cohort study enrolled approximately 900 consecutive patients on dialysis between May 2019 and January 2021. Enrolled subjects were evaluated at baseline for demographic information, laboratory tests, radiologic imaging, and bone mineral densitometry (BMD) scans. After enrollment, regular assessments of the patients were performed, and their biospecimens were collected according to the study protocol. The primary outcomes were the occurrence of major adverse cardiovascular events, invasive treatment for peripheral artery disease, and osteoporotic fractures. The secondary outcomes were hospitalization for cerebrovascular disease or progression of abdominal aortic calcification. Participants will be assessed for up to 3 years to determine whether primary or secondary outcomes occur. Results: Between May 2019 and January 2021, all participating centers recruited 900 consecutive dialysis patients, including 786 undergoing hemodialysis (HD) and 114 undergoing peritoneal dialysis (PD). The mean age of the subjects was 60.4 ± 12.3 years. Males accounted for 57.7% of the total population. The mean dialysis vintage was 6.1 ± 6.0 years. The HD group was significantly older, had a longer dialysis vintage, and more comorbidities. Overall, the severity of vascular calcification was higher and the level of BMD was lower in the HD group than in the PD group. Conclusion: This nationwide, multicenter, prospective cohort study focused on chronic kidney disease-mineral and bone disorder and aimed to provide clinical evidence to establish optimal treatment guidelines for Asian dialysis patients.
ISSN:1420-4096
1423-0143
1423-0143
DOI:10.1159/000539030