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The DCOR Study

The DCOR Study. The DCOR Study. Dialysis Clinical Outcomes Revisited (DCOR) Randomized Trial Using Claims Data. Reference

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The DCOR Study

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  1. The DCOR Study

  2. The DCOR Study Dialysis Clinical Outcomes Revisited (DCOR) Randomized Trial Using Claims Data Reference St. Peter WL, Liu J, Weinhandl E, et al. A comparison of sevelamer and calcium-based phosphate binders on mortality, hospitalization, and morbidity in hemodialysis: a secondary analysis of the Dialysis Clinical Outcomes Revisited (DCOR) randomized trial using claims data. Am J Kidney Dis. 2008;51:445–454.

  3. Background Observational studies have indicated that increased levels of phosphorus, calcium, and calcium–phosphorus products may be associated with greater mortality rates in dialysis patients. A few studies have reported a decreased risk of coronary calcification in hemodialysis patients with sevelamer as compared to calcium-based phosphate binders. St. Peter et al. compared the effects of sevelamer with calcium-based phosphate binders on mortality and hospitalization in hemodialysis patients. This study is summarized in this article.

  4. Aim To compare the effects of sevelamer with calcium-based phosphate binders on mortality and hospitalization in hemodialysis patients.

  5. Methods

  6. Results • All-cause (17.7 vs 17.4 deaths/100 patient-years; P=0.8 unadjusted; P=0.9 adjusted) and cardiovascular mortality (9.0 vs 8.2 deaths/100 patient-years; P=0.3 unadjusted; P=0.4 adjusted) did not differ significantly between treatment groups (Fig. 1). • First hospitalization, cause-specific multiple hospitalizations, first morbidity, and multiple morbidity rates did not differ significantly between treatment groups. • Multiple all-cause hospitalization rate (1.7 vs 1.9 admissions/patient-year; P=0.03 unadjusted; P=0.02 adjusted) and hospital days (12.3 vs 13.9 days/patient-year; P=0.05 unadjusted; P=0.03 adjusted) were lower in the sevelamer group.

  7. Conclusions Treatment with sevelamer, as compared to calcium-based binders did not affect overall mortality, cause-specific mortality, morbidity, or first or cause-specific hospitalization. Nevertheless, there was evidence for a beneficial effect on multiple all-cause hospitalizations and hospital days. Treatment with sevelamer, as compared to calcium-based binders did not affect overall mortality, cause-specific mortality, morbidity, or first or cause-specific hospitalization.

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