Dialysis initiation improves calcification propensity

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2020-03, Vol.35 (3), p.495-502
• Main Authors: Ponte, Belen, Pruijm, Menno, Pasch, Andreas, Dufey-Teso, Anne, Martin, Pierre-Yves, de Seigneux, Sophie
• Format: Article
• Language: English
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfz222

Abstract Background Cardiovascular morbidity and mortality is high in patients starting dialysis and could be related to modifications of calcification inducers and inhibitors by dialysis, promoting cardiovascular events. The impact of dialysis initiation on serum calcification propensity evolution and arterial stiffness is unknown. We therefore prospectively determined the evolution of the one-half maximal transition time (T50) value and its main determinants as well as pulse wave velocity over the first 3 months of dialysis initiation. Methods We analysed the evolution of T50, fetuin-A and mineral metabolism parameters before dialysis initiation (M0) and monthly until Month 3 (M3) in incident patients starting haemodialysis (HD) or peritoneal dialysis (PD) in two tertiary Swiss university hospitals. Arterial stiffness was assessed by pulse tonometry at M0 and M3 and biological parameters were compared between M0 and M3 and before/after HD. Linear mixed models were used to assess parameter evolution over time, taking into account repeated measures and other influencing variables. Results Forty-six patients on HD and 12 on PD were followed. Among them, 45 were male (78%) with a median age of 67 years (25th–75th quartile range 54–77). T50 significantly increased between M0 and M3 from 183 (120–266) to 246 min (175–330) (P