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Kidney Week

Abstract: TH-PO0322

Changes in Coronary Artery Calcification Score in ESKD: Comparison of Conventional and Nocturnal Hemodialysis

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Doi, Toshiki, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Morii, Kenichi, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Nishizawa, Yoshiko, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Mizuiri, Sonoo, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Yamashita, Kazuomi, Ichiyokai Harada Hospital, Hiroshima, Japan
  • Masaki, Takao, Hiroshima Daigaku Hospital, Hiroshima, Japan
Background

Nocturnal hemodialysis (NHD) refers to hemodialysis performed at night during sleep. NHD allows patients to better use their time for family interaction, work, and other daily activities. Compared to conventional hemodialysis (HD), NHD is performed slowly and for a more extended period, which is expected to help prevent complications commonly seen in dialysis patients. Several studies have also reported the clinical benefits of this approach.
The coronary artery calcification score (CACS), measured by multi-slice CT, has significant evidence linking it to cardiovascular events, and its usefulness has been reported in dialysis patients. In this study, we compared changes in CACS between conventional HD treatment and NHD treatment in maintenance dialysis patients.

Methods

A retrospective cohort study was conducted on dialysis patients who underwent CACS evaluation using CT at our institution from 2018 to 2021. Patients who did not undergo re-evaluation after two years and those with a logarithmically transformed initial Agatston CACS of less than 30 were excluded. The patients were classified into the HD group (3 times/week, 4-5 h per session) and the NHD group (3 times/week, 8 h per session). Propensity score matching was performed based on age, sex, dialysis vintage, presence of diabetes, calcium, phosphorus level, and initial Agatston CACS. Calcium and phosphorus levels in the NHD group were based on data obtained during conventional HD before switching. The aim was to examine whether there was a difference in the change rate of the Agatston CACS after two years between the HD and NHD groups. The data were presented as medians and interquartile ranges, and JMP pro 18 was used for analysis. Mann-Whitney U tests were used for statistical testing.

Results

CACS were measured in 220 patients at a two-year interval during the study period, of whom 15 received NHD. Through propensity score matching, 12 patients were selected for each group. No significant differences were observed in the baseline characteristics between the groups. The median increase rate of the Agatston CACS after two years was 66.9% (interquartile range 19.6 – 107.7) in the HD group and 7.8% (-4.8 – 31.1) in the NHD group (p = 0.02).

Conclusion

NHD may suppress coronary artery calcification compared to conventional HD in dialysis patients.

Digital Object Identifier (DOI)