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Citric acid-based bicarbonate dialysate attenuates aortic arch calcification in maintenance hemodialysis patients: a

Ken-Ichi Akiyama1, Takahito Moriyama2,3, Norio Hanafusa4

  • 1Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 1628666, Japan.

Journal of Nephrology
|October 19, 2022
PubMed

Insights

Citric acid-based bicarbonate dialysate (CD) significantly slowed aortic arch calcification progression in hemodialysis patients compared to acetic acid-based dialysate (AD). This suggests CD may be a beneficial intervention for reducing vascular calcification in this population.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Medical Imaging

Background:

  • Aortic calcification progression is linked to mortality in hemodialysis patients.
  • Blood calciprotein particle (CPP) levels correlate with coronary artery calcification.
  • Citric acid-based bicarbonate dialysate (CD) may inhibit CPP formation.

Purpose of the Study:

  • To investigate the impact of CD on aortic arch calcification score (AoACS) progression.
  • To assess the effect of CD on blood CPP levels in hemodialysis patients.

Main Methods:

  • A 12-month observational study of 262 hemodialysis patients.
  • AoACS evaluated via chest X-ray (0-16 points); progression defined as ΔAoACS > 0.
  • Propensity score matching used to compare CD and acetic acid-based dialysate (AD) groups.

Main Results:

  • AoACS progression rate was significantly lower in the CD group versus the AD group (P=0.002 after matching).
  • CD was significantly associated with reduced AoACS progression (OR 0.52; P=0.025).

Conclusions:

  • Citric acid-based bicarbonate dialysate (CD) may slow vascular calcification progression in hemodialysis patients.
  • CD shows potential as a therapeutic strategy to mitigate calcification in this high-risk group.
Abstract

Keywords:
Aortic arch calcification scoreCalciprotein particleCitric acid-based bicarbonate dialysateHemodialysis

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