Kidney Week

Abstract: FR-PO0256

Assessing Serial Changes in Aortic Calcification in Patients on Hemodialysis with 18F-Sodium Fluoride (NaF) Positron Emission Tomography (PET)/CT and Bone Biomarkers

Session Information

• Bone and Mineral Metabolism: Clinical Epidemiology and Outcomes
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Bone and Mineral Metabolism

• 502 Bone and Mineral Metabolism: Clinical

Authors

• Absar, Hasib, Fresenius Medical Care Holdings Inc, New York, New York, United States

Hasib Absar, MSc

• Kakembo, Mark, Fresenius Medical Care Holdings Inc, New York, New York, United States

Mark Kakembo

• Dong, Zijun, Fresenius Medical Care Holdings Inc, New York, New York, United States

Zijun Dong

• Wang, Lin-Chun, Fresenius Medical Care Holdings Inc, New York, New York, United States

Lin-Chun Wang, MS

• Wang, Xiaoling, Fresenius Medical Care Holdings Inc, New York, New York, United States

Xiaoling Wang, PhD

• Tisdale, Lela, Fresenius Medical Care Holdings Inc, New York, New York, United States

Lela Tisdale

• Ren, Sarah, Renal Research Institute, New York, New York, United States

Sarah Ren

• Rivera Fuentes, Lemuel, Renal Research Institute, New York, New York, United States

Lemuel Rivera Fuentes, MD

• Thijssen, Stephan, Fresenius Medical Care Holdings Inc, New York, New York, United States

Stephan Thijssen, DrMed

• Dutruel, Silvina P, Weill Cornell Medicine, New York, New York, United States

Silvina P Dutruel, MD

• Grobe, Nadja, Fresenius Medical Care Holdings Inc, New York, New York, United States

Nadja Grobe, PhD

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko, MD, FASN

• Dyke, Jonathan, Weill Cornell Medicine, New York, New York, United States

Jonathan Dyke, PhD

Background

Vascular Calcification (VC) contributes to morbidity and mortality in dialysis patients. This prospective observational study assessed whether osteoblastic turnover in aortic VC, quantified by ¹⁸F-NaF PET/CT, correlates with serum bone biomarkers.

Methods

Seven maintenance hemodialysis patients (3F/4M, 65.0±4.5 yrs) were enrolled. We performed ¹⁸F-NaF PET/CT at baseline and after 8-12 months and computed K_patlak using the Patlak method. Serum bone biomarkers were measured at baseline and four time-points during follow-up. Calcification inhibition was analyzed by measuring T50, the half-maximal time for calciprotein particle (CPP1) transformation to CPP2, and the CPP2 radius at baseline and at month 10 (Calciscon AG, Switzerland

Results

Six subjects completed baseline PET/CT imaging and five completed follow-ups. Aortic VC was evident on both ¹⁸F-NaF PET and CT scans (Fig.1A, B). During follow-up, K_patlak increased by 11% (p=0.005; Fig.1C), indicating elevated osteoblastic turnover within the aortic VC. Serum bone biomarkers showed no significant change (all p > 0.05; Fig. 1D–I). Neither T50 nor CPP2 radius correlated with K_patlak (Fig.1 J, K).

Conclusion

¹⁸F-NaF PET/CT identified increased osteoblastic activity within aortic VC, whereas serum bone turnover biomarkers, T50, and CPP2 radius showed non-significant changes. Longer study periods may be needed to determine whether these biomarkers can reliably reflect VC progression.

Figure 1. Longitudinal trends in biomarkers. (A, B) ¹⁸F-NaF PET/CT, CT imaging of aortic calcification. (C) K_patlak increased by 11% over the study period (p=0.005). (D–K) parathyroid hormone (PTH), calcium, phosphorus, bone alkaline phosphatase (BAP), soluble α-klotho, tartrate-resistant acid phosphatase 5b (TRAP5b), T50 and CPP2 radius showed no significant changes by linear mixed modeling.

Funding

• Commercial Support – Renal Research Institute

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20258832j14h