Reduction of dialysate calcium level reduces progression of coronary artery calcification and improves low bone turnover in patients on hemodialysis
Küçük Resim Yok
Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
American Society of Nephrology
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Exposure to high Ca concentrations may influence the development of low-turnover bone disease and coronary artery calcification (CAC) in patients on hemodialysis (HD). In this randomized, controlled study, we investigated the effects of lowering dialysate Ca level on progression of CAC and histologic bone abnormalities in patients on HD. Patients on HD with intact parathyroid hormone levels #300 pg/ml receiving dialysate containing 1.75 or 1.50mmol/L Ca (n=425) were randomized to the 1.25-mmol/L Ca (1.25 Ca; n=212) or the 1.75-mmol/L Ca (1.75 Ca; n=213) dialysate arm. Primary outcome was a change in CAC score measured by multislice computerized tomography; main secondary outcome was a change in bone histomorphometric parameters determined by analysis of bone biopsy specimens. CAC scores increased from 4526869 (mean6SD) in the 1.25 Ca group and 5006909 in the 1.75 Ca group (P=0.68) at baseline to 61661086 and 80361412, respectively, at 24 months (P=0.25). Progression rate was significantly lower in the 1.25 Ca group than in the 1.75 Ca group (P=0.03). The prevalence of histologically diagnosed lowbone turnover decreased from85.0% to 41.8%in the 1.25 Ca group (P=0.001) and did not change in the 1.75 Ca group. At 24 months, bone formation rate, trabecular thickness, and bone volume were higher in the 1.25 Ca group than in the 1.75 Ca group. Thus, lowering dialysate Ca levels slowed the progression of CAC and improved bone turnover in patients on HD with baseline intact parathyroid hormone levels #300 pg/ml. Copyright © 2016 by the American Society of Nephrology.
Açıklama
Anahtar Kelimeler
Kaynak
Journal of the American Society of Nephrology
WoS Q Değeri
Scopus Q Değeri
Q1
Cilt
27
Sayı
8
