Canaud, Bernard

Dekker, Marijke

Konings, Constantijn

Kooman, Jeroen

Pasch, Andreas

van der Sande, Frank

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DIALYSIS. CARDIOVASCULARCOMPLICATIONS - 2SP544 CALCIFICATION PROPENSITY OF HEMODIALYSIS ANDHEMODIAFILTRATION PATIENTSMarijke Dekker1, Constantijn Konings1, Bernard Canaud2, Andreas Pasch3,Frank van der Sande4 and Jeroen Kooman41Catharina Hospital Eindhoven, Internal Medicine / Nephrology, Eindhoven, TheNetherlands, 2Fresenius, Medical Care, Bad Homburg, Germany, 3UniversityHospital Bern, Clinical Chemistry, Bern, Switzerland, 4Maastricht UniversityMedical Center, Internal Medicine / Nephrology, Maastricht, The NetherlandsIntroduction and Aims: Increased vascular calcification in dialysis patients, due tohyperphosphatemia in combination with decreased calcification inhibitorconcentrations as Fetuin A (Fet-A), is an independent predictor for cardiovascularmortality. Fet-A, calcium (Ca) and phosphate (P) form calciprotein particles (CPPs),protein mineral complexes with transform from primary CPP to more stable secondaryCPP. This is the underlying principle of a novel blood test for the measurement ofcalcification propensity (T50). The effects of hemodialysis (HD) and hemodiafiltration(HDF) on the clearance of Fet-A and the T50 value have never been studied.Methods: In this cross-sectional pilot study we included stable prevalent HD and HDFpatients treated on a 4 hours three times weekly basis at the Catharina Hospital inEindhoven, the Netherlands. We included patients with a dialysis vintage of at least 3months and a vascular access providing a blood flow rate of at least 300ml/min in bothgroups. Measurements were performed in the first week of October 2014 during allin-centre dialysis sessions.Results: 64 patients (mean age 70 years, 53,1% male, vintage 50 months, 53.1%postdilution HDF (mean substitution volume 21.3±4.5L) and 46.9% high-flux HD)were included, in total 376 samples were analysed. Patients were divided in two groupsbased on dialysis modality. Fet-A and T50 pre- and post-dialysis were 0,37(±0,07)-0,41(±0,08) g/L and 244(±64)-301(±57) min in the HD group and 0,40(±0,07)-0,41(±0,08)g/L and 253 (±55)-304(±61) min in the HDF group. The delta values of Ca, P andalbumin (Alb) were equal in both groups. The delta-T50 was mostly influenced bydelta-P (r2-0.342; p = 0.002 HD and r2-0.420; p <0.001 HDF) and delta-Fet-Aconcentrations by the delta-Alb concentration (r20.482; p < 0.001 HD and r2 0.396; p =<0.001 HDF) of one dialysis session in both groups.Conclusions: Calcification propensity score is significantly reduced by HD and HDFsessions as measured by transition time from primary to secondary CPP levels, but HDand HDF patients present with same baseline vascular calcification risk valuespredialysis. Phosphate clearance during dialysis strongly and favourably influences T50.These results deserve further studies to identify the best strategy to improvecalcification risk.© The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.Nephrology Dialysis Transplantation 30 (Supplement 3): iii556–iii569, 2015doi:10.1093/ndt/gfv197.11

SP544CALCIFICATION PROPENSITY OF HEMODIALYSIS AND HEMODIAFILTRATION PATIENTS

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SP544CALCIFICATION PROPENSITY OF HEMODIALYSIS AND HEMODIAFILTRATION PATIENTS

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