Impact of Short Daily at Home Hemodialysis on Attenuation of Vascular Calcification

Vascular Calcification (VC) has a significant effect in cardiovascular disease on dialysis patients. However no pharmacological interventions have been demonstrated for prevention and/or attenuation of VC. Recent advances with frequent hemodialysis have shown the reduction of hyperphosphatemia. This has led to the idea that there is a strong relation between VC and hyperphosphatemia which suggests therefore, that frequent hemodialysis may reduce VC. Aim: To examine whether short daily at-home hemodialysis reduces VC. Method: Using Volume Viewer software with a 16-detector CT scan, the total calcification volume of the aorta was calculated with a cut-of of 130 House field Units. Abdominal CT scans were taken prior to and 3 years after the start of short daily at-home hemodialysis in 37 patients (average age 52 ± 7.0 years, male 33). The underlying kidney diseases were chronic glomeurlonephritis (33), diabetic nephropathy (2) and congenital kidney disease (2). Results: The mean base line calcification score of the abdominal aorta was 7.59 ± 3.49 (cm3), which was reduced by short daily at-home hemodialysis to 6.69 ± 3.57 at the end of the study (P<0.05). Besides, short daily at-home hemodialysis produced normalization of blood pressure, reduction of blood urea nitrogen and serum phosphate, which contribute to vascular calcification. Conclusion: This is the first demonstration that short daily at-home hemodialysis reduces calcification of the abdominal aorta through attenuation of hyperphosphatemia. (Words: 222).