ウシオ　ユウスケ   USHIO Yuusuke   潮　雄介    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Citric acid-based bicarbonate dialysate attenuates aortic arch calcification in maintenance hemodialysis patients: a retrospective observational study.
掲載誌名	正式名：Journal of nephrology 略　 称：J Nephrol ISSNコード：17246059/11218428
巻・号・頁	36(2),pp.367-376
著者・共著者	Akiyama Ken-Ichi, Moriyama Takahito, Hanafusa Norio, Miura Yutaka, Seki Momoko, Ushio Yusuke, Kawasoe Kentaro, Miyabe Yoei, Karasawa Kazunori, Sugiura Hidekazu, Uchida Keiko, Okazaki Masayuki, Komatsu Mizuki, Kawaguchi Hiroshi, Kuro-O Makoto, Nitta Kosaku, Hoshino Junichi
発行年月	2023/03
概要	BACKGROUND:Progression of aortic calcification is associated with all-cause and cardiovascular mortality in hemodialysis patients. Blood calciprotein particle (CPP) levels are associated with coronary artery calcification and were reported to be inhibited when using citric acid-based bicarbonate dialysate (CD). Therefore, this study aimed to examine the effect of CD on the progression of the aortic arch calcification score (AoACS) and blood CPP levels in hemodialysis patients.METHODS:A 12-month retrospective observational study of 262 hemodialysis patients was conducted. AoACS was evaluated by calculating the number of calcifications in 16 segments of the aortic arch on chest X-ray (minimum score is 0; maximum score is 16 points). The patients were divided into the following groups according to their baseline AoACS: grade 0, AoACS = 0 points; grade 1, AoACS 1-4 points; grade 2, AoACS 5-8 points; grade 3, AoACS 9 points or higher. Patients on bisphosphonates or warfarin or with AoACS grade 3 were excluded. Progression, defined as ΔAoACS (12-month score - baseline score) > 0 points, was compared between the CD and acetic acid-based bicarbonate dialysate (AD) groups before and after adjusting the background using propensity score matching.RESULTS:The AoACS progression rate was significantly lower in the CD group than in the AD group (before matching: P = 0.020, after matching: P = 0.002). Multivariate logistic regression analysis showed that CD was significantly associated with AoACS progression (odds ratio 0.52, 95% confidence interval 0.29‒0.92, P = 0.025).CONCLUSION:CD may slow the progression of vascular calcification in hemodialysis patients.
DOI	10.1007/s40620-022-01470-2
PMID	36261704