Work

Fp631effects of Sodium Thiosulfate on Calcification of Iliac Arteries in Hemodialysis Patients- a Interventional Double Blind Randomized Placebo Controlled Study

Year: 2019

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: INTRODUCTION: Although a lot is known about pathogenesis and outcome of vascular calcification in hemodialysis (HD) population, there is little data on the treatment of established extraosseous calcification. The aim of the present study was to determine the absolute change in the iliac artery calcification score determined using a 16-slice computed tomography (CT) scanner and using the Agatston method. METHODS: Out of 65 screened patients we recruited 60 patients with an abdominal aorta Agatston calcification score ≥ 100. The scores of the left and right iliac artery were combined to yield the iliac artery Agatston calcification score (IACS) and iliac artery calcification volume score (IACV). Thirty patients were randomized to receive NaTS 25 g/1.73 m² and 30 patients to receive 100 ml of 0.9 % NaCl intravenously during the last 15 minutes of HD over a period of six months. 55 patients finished the study and the effect of therapy was analyzed by repeated CT. RESULTS: There were no significant differences between the groups regarding any of the basal parameters assessed (Table 1). As shown in Table 2, the mean Agatston score of the iliac arteries decreased in the NaTS but not the saline group. The difference in absolute change of IACS (ΔIACS) the two groups was statistically significant (p=0.049). Univariate logistic regression analysis was used to assess the impact of several factors on the probability of IACS progression in a model contained 12 independent variables: gender, age, smoking, dialysis vintage, Kt/V, diabetes, NaTS therapy, corrected calcium, serum phosphorus, phosphate binder, calcitriol and iPTH. We found that none of the 12 parameters was a significant predictor of IACS calcification progress. During the treatment period, there were no adverse events related to the applied . CONCLUSIONS: STS showed to be safe and efficient therapy in slowing the progression of vascular calcification in the region of iliac arteries over the period of 6 months. Further studies are needed to confirm the finding in other vascular beds.

Source: Nephrology Dialysis Transplantation

DOI: 10.1093/ndt/gfz106.fp631