Affiliation:
1. Shonan Kamakura General Hospital
Abstract
AbstractBackground This interventional study aimed to assess the relationship between high and low bicarbonate dialysis and quantitatively measure coronary artery calcification (CAC) using multi-slice computed tomography (MSCT) in patients undergoing haemodialysis (HD). Methods We used two dialysates with different bicarbonate concentrations (Kindaly 3E®and Carbostar PⓇ) to evaluate the effects of dialysate bicarbonate concentration on CAC progression. Kindaly 3EⓇwas an acetic-acid dialysate with a dialysate calcium (dCa) concentration of 2.5 mEq/L and a bicarbonate concentration of 25 mmol/L. Carbostar PⓇwas a citric-acid dialysate with a dCa concentration of 3.0 mEq/L and a bicarbonate concentration of 35 mmol/L. The Kindaly 3EⓇdialysate was used for all patients for the first 6 months of the study period, and the Carbostar PⓇdialysate was used for all patients for the second 6 months of the study period. Results Fifty-three patients undergoing HD underwent MSCT at study initiation, whereas 45 underwent follow-up MSCT 6 and 12 months later to evaluate the CAC score (CACS). The serum calcium and phosphorus levels did not change significantly during the study period. Intact parathyroid hormone levels were significantly increased, although both bone alkaline phosphatase and tartrate-resistant acid phosphatase-5b levels were significantly decreased after 6 months of Carbostar P®use. Conclusions Pre-HD bicarbonate levels and CACS changes over a 6-month period (ΔCACS) were significantly higher with Carbostar P®than with Kindaly 3EⓇ. Trial RegistrationThe study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Tokushukai Medical Group (TGE01018-008 22/5/2018; TGE-1018-024; 29/11/2018). The University hospital Medical Information Network-Clinical trials registry (UMIN-CTR) number is UMIN000035085 (30/11/2018).
Publisher
Research Square Platform LLC