{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T06:54:48Z","timestamp":1768200888820,"version":"3.49.0"},"reference-count":35,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,8,31]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To define groups of patients according to the changes of biochemical parameters, that is, serum calcium, phosphate and parathyroid hormone (PTH), over a 2-year follow-up period using group-based multi-trajectory modeling (GBMM) among a cohort of dialysis patients with newly diagnosed secondary hyperparathyroidism (SHPT) (ie, PTH\u2265500\u2005ng\/L for the first time) and to compare their patient characteristics and treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Pharmacoepidemiological study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>In the 12 dialysis units located in the French region of Lorraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 269 dialysis patients with newly diagnosed SHPT were prospectively included from December 2009 to May 2012 and followed-up for 2\u2005years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified four distinct trajectory groups: \u2018rapid PTH drop\u2019 experiencing a rapid and sharp decrease (over weeks) in PTH level associated with decreasing phosphate level within normal range (n=34; 12.7%), \u2018gradual PTH decrease\u2019 experiencing a gradual and continuous decrease (over months) in PTH level and maintaining phosphate at a middle level throughout the study (n=98; 36.4%), \u2018slow PTH decrease with high phosphate\u2019 experiencing a slow decrease in PTH level associated with a relatively high phosphate level (n=105; 39.0%) and \u2018uncontrolled SHPT\u2019 with high levels of PTH and phosphate throughout the study (n=32; 11.9%). Patients in the \u2018uncontrolled SHPT\u2019 group were significantly (p&lt;0.00001) younger than patients in other groups. Kidney Disease Improving Global Outcomes (KDIGO) targets for PTH, phosphate and calcium were reached simultaneously for 14.9% of patients at baseline and 16.7% at the end of the study. Patients were given cinacalcet more frequently at months 3 and 6 in the \u2018rapid PTH drop\u2019 and at month 24 in the \u2018uncontrolled SHPT\u2019 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Over 2\u2005years following a new SHPT diagnosis, a younger age and a higher rate of alkaline phosphatase were associated to a continuous uncontrolled SHPT. Patients with the lowest PTH at the end of the follow-up tended to receive more often cinacalcet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/show\/nct02888639\" ext-link-type=\"uri\">ClinicalTrials.gov number, NCT02888639<\/jats:ext-link>\n                      , post results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-011482","type":"journal-article","created":{"date-parts":[[2017,3,27]],"date-time":"2017-03-27T20:23:18Z","timestamp":1490646198000},"page":"e011482","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Trajectories of CKD-MBD biochemical parameters over a 2-year period following diagnosis of secondary hyperparathyroidism: a pharmacoepidemiological study"],"prefix":"10.1136","volume":"7","author":[{"given":"Pierre","family":"Filipozzi","sequence":"first","affiliation":[{"name":"Department of Nephrology, University Hospital, Vand\u0153uvre-l\u00e8s-Nancy, France"},{"name":"N\u00e9phrolor Network of Care, Vand\u0153uvre-l\u00e8s-Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole","family":"Ayav","sequence":"additional","affiliation":[{"name":"N\u00e9phrolor Network of Care, Vand\u0153uvre-l\u00e8s-Nancy, France"},{"name":"P\u00f4le S2R, Epidemiology and Clinical Evaluation, University Hospital, Vand\u0153uvre-l\u00e8s-Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willy","family":"Ngueyon Sime","sequence":"additional","affiliation":[{"name":"P\u00f4le S2R, Epidemiology and Clinical Evaluation, University Hospital, Vand\u0153uvre-l\u00e8s-Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Laurain","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital, Vand\u0153uvre-l\u00e8s-Nancy, France"},{"name":"N\u00e9phrolor Network of Care, Vand\u0153uvre-l\u00e8s-Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mich\u00e8le","family":"Kessler","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital, Vand\u0153uvre-l\u00e8s-Nancy, France"},{"name":"N\u00e9phrolor Network of Care, Vand\u0153uvre-l\u00e8s-Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Brunaud","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary, Digestive and Endocrine Surgery, University Hospital, Vand\u0153uvre-l\u00e8s-Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc","family":"Frimat","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital, Vand\u0153uvre-l\u00e8s-Nancy, France"},{"name":"N\u00e9phrolor Network of Care, Vand\u0153uvre-l\u00e8s-Nancy, France"},{"name":"Lorraine University, Paris Descartes University, Nancy, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,3,27]]},"reference":[{"key":"2025121407233750000_7.3.e011482.1","first-page":"S1","article-title":"KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)","volume":"113","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group","year":"2009","journal-title":"Kidney Int"},{"key":"2025121407233750000_7.3.e011482.2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.11.044"},{"key":"2025121407233750000_7.3.e011482.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.285122"},{"key":"2025121407233750000_7.3.e011482.4","unstructured":"Network and epidemiologic information in nephrology: kidney report 2010[In-ternet]. 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