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Chronic kidney disease–mineral bone disorder (CKD-MBD) is the most common complication in CKD patients. Although there is a consensus on treatment guidelines for CKD-MBD, it remains uncertain whether these treatment recommendations reflect actual practice. Therefore, the aim of this study was to investigate the CKD-MBD medication trend in real-world practice. This was a retrospective and observational study using a 12-year period database transformed into a common data model from three tertiary university hospitals. Study populations were subjects initially diagnosed as CKD. The date of diagnosis was designated as the index date. New patients were categorized year to year from 2008 to 2019 with a fixed observation period of 365 days to check the prescription of CKD-MBD medications including calcium-containing phosphate binder, noncalcium-containing phosphate binder, aluminium hydroxide, vitamin D receptor activator (VDRA), and cinacalcet. The numbers of CKD patients in the three hospitals were 7555, 2424, and 5351, respectively. The proportion for patients with CKD-MBD medication prescription decreased yearly regardless of hospital and CKD stage (p for trend < 0.05). The use of aluminium hydroxide disappeared steadily while the use of VDRA increased annually in all settings. Despite these changes in prescription patterns, the mean value for CKD-MBD-related serologic markers was almost within target range. The proportion of the population within the target value was not significantly changed. Irrespective of hospital and CKD stage, similar trends of prescription for CKD-MBD medications were observed in real-world practice. Further research with a distributed network study may be helpful to understand medication trends in CKD-MBD treatment. [ABSTRACT FROM AUTHOR]

Background: Joint replacement is an important surgery for replacing a damaged joint with prosthesis. Implants used for joint replacement are made of metal, plastic, and ceramic. Skin reactions, such as dermatitis, can occur due to a hypersensitivity to these external substances. Aims: The aim of this study was to find the relationship between joint replacement and dermatitis. Methods: A nationwide population-based retrospective cohort study was performed using the National Health Insurance Service Database of the Republic of Korea. A total of 40,218 patients who underwent joint replacement were enrolled as the operation group and 40,218 controls were also enrolled. A cox proportional hazard regression model, and Fine and Gray regression model were used to compare the risk of dermatitis between the two groups. Results: Dermatitis occurred in 9.2% of the operation group and 9.1% of the control group, and no statistical difference was observed between the two groups. According to the Cox proportional hazard regression model, and Fine and Gray regression model, the risk of dermatitis did not increase in the operation group compared to that in the control group. However, the risk of dermatitis increased 1.20-fold in the operation group compared to that in the control group aged <60 years according to the Fine and Gray regression model (95% confidence index (CI) = 1.05–1.37, P = 0.0008). Conversely, no difference in dermatitis risk was observed between the two groups aged ≥60 years. Conclusions: We found that the risk of dermatitis increased after joint replacement in those aged <60 years. [ABSTRACT FROM AUTHOR]