{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:28:23Z","timestamp":1778826503440,"version":"3.51.4"},"reference-count":50,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2012,9,20]],"date-time":"2012-09-20T00:00:00Z","timestamp":1348099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Several observational studies have indicated that vitamin D receptor activators (VDRA), including <jats:italic>paricalcitol<\/jats:italic>, are associated with greater survival in maintenance hemodialysis (MHD) patients. However, patients with higher serum parathyroid hormone, a surrogate of higher death risk, are usually given higher VDRA doses, which can lead to confounding by indication and attenuate the expected survival advantage of high VDRA doses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined mortality\u2010predictability of low (&gt;1 but &lt;10\u2009\u00b5g\/week) versus high (\u226510\u2009\u00b5g\/week) dose of administered <jats:italic>paricalcitol<\/jats:italic> over time in a contemporary cohort of 15\u2009442 MHD patients (age 64\u2009\u00b1\u200915\u2009years, 55% men, 44% diabetes, 35% African\u2013Americans) from all DaVita dialysis clinics across the USA (7\/2001\u20136\/2006 with survival follow\u2010ups until 6\/2007) using conventional Cox regression, propensity score (PS) matching, and marginal structural model (MSM) analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our conventional Cox models and PS matching models, low dose of <jats:italic>paricalcitol<\/jats:italic> was not associated with mortality either in baseline (hazard ratio (HR): 1.03, 95% confidence interval (CI): (0.97\u20131.09)) and (HR: 0.99, 95%CI:(0.86\u20131.14)) or time\u2010dependent (HR: 1.04, 95%CI: (0.98\u20131.10)) and (HR: 1.12, 95%CI: (0.98\u20131.28)) models, respectively. In contrast, compared to high dose of <jats:italic>paricalcitol<\/jats:italic>, low dose was associated with a 26% higher risk of mortality (HR: 1.26, 95%CI: (1.19\u20131.35)) in MSM. The association between dose of <jats:italic>paricalcitol<\/jats:italic> and mortality was robust in almost all subgroups of patients using MSMs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Higher dose of <jats:italic>paricalcitol<\/jats:italic> appears causally associated with greater survival in MHD patients. Randomized controlled trials need to verify the survival effect of <jats:italic>paricalcitol<\/jats:italic> dose in MHD patients are indicated. Copyright \u00a9 2012 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.3349","type":"journal-article","created":{"date-parts":[[2012,9,20]],"date-time":"2012-09-20T23:27:41Z","timestamp":1348183661000},"page":"1232-1239","source":"Crossref","is-referenced-by-count":20,"title":["Administered paricalcitol dose and survival in hemodialysis patients: A marginal structural model analysis"],"prefix":"10.1002","volume":"21","author":[{"given":"Jessica E","family":"Miller","sequence":"first","affiliation":[{"name":"Harold Simmons Center for Chronic Disease Research and Epidemiology Los Angeles Biomedical Research Institute at Harbor\u2010UCLA Medical Center  Torrance CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miklos Z","family":"Molnar","sequence":"additional","affiliation":[{"name":"Harold Simmons Center for Chronic Disease Research and Epidemiology Los Angeles Biomedical Research Institute at Harbor\u2010UCLA Medical Center  Torrance CA 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