Petar Djuric1, Nada Dimkovic1,2, Georg Schlieper3,4, Zivka Djuric1, Milan Pantelic5, Milica Mitrovic6, Aleksandar Jankovic1, Marko Milanov7, Jovana Kuzmanovic Pficer8, Jürgen Floege3. 1. Clinical Department for Nephrology, Zvezdara University Medical Center, Belgrade, Serbia. 2. Medical Faculty, University of Belgrade, Belgrade, Serbia. 3. Division of Nephrology and Immunology, Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany. 4. Center for Nephrology, Hypertension, and Metabolic Diseases, Hannover, Germany. 5. Center for Radiology, Zvezdara University Medical Center, Belgrade, Serbia. 6. Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Beograd, Serbia. 7. Clinical Department for Cardiology, Zvezdara University Medical Center, Belgrade, Serbia. 8. Department for Medical Statistics and Informatics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
Abstract
BACKGROUND:Sodium thiosulphate (NaTS) is mostly used in haemodialysis (HD) patients with calcific uraemic arteriolopathy. This double-blind, randomized, placebo-controlled study assessed the effect of NaTS on progression of cardiovascular calcifications in HD patients. METHODS: From 65 screened patients, we recruited 60 patients with an abdominal aorta Agatston calcification score ≥100. Thirty patients were randomized to receive NaTS 25 g/1.73 m2 and 30 patients to receive 100 mL of 0.9% sodium chloride intravenously during the last 15 min of HD over a period of 6 months. The primary endpoint was the absolute change of the abdominal aortic calcification score. RESULTS: The abdominal aortic calcification score and calcification volume of the abdominal aorta increased similarly in both treatment groups during the trial. As compared with the saline group, patients receiving NaTS exhibited a reduction of their iliac artery calcification score (-137 ± 641 versus 245 ± 755; P = 0.049), reduced pulse wave velocity (9.6 ± 2.7 versus 11.4 ± 3.6; P = 0.000) and a lower carotid intima-media thickness (0.77 ± 0.1 versus 0.83 ± 00.17; P = 0.033) and had better preservation of echocardiographic parameters of left ventricular hypertrophy. No patient of the NaTS group developed new cardiac valve calcifications during the trial as compared with 8 of 29 patients in the saline group. By univariate analysis, NaTS therapy was the only predictor of not developing new valvular calcifications. No adverse events possibly related to NaTS infusion were noted. CONCLUSIONS: While NaTS failed to retard abdominal aortic calcification progress, it positively affected calcification progress in iliac arteries and heart valves as well as several other cardiovascular functional parameters.
RCT Entities:
BACKGROUND:Sodium thiosulphate (NaTS) is mostly used in haemodialysis (HD) patients with calcific uraemic arteriolopathy. This double-blind, randomized, placebo-controlled study assessed the effect of NaTS on progression of cardiovascular calcifications in HD patients. METHODS: From 65 screened patients, we recruited 60 patients with an abdominal aorta Agatston calcification score ≥100. Thirty patients were randomized to receive NaTS 25 g/1.73 m2 and 30 patients to receive 100 mL of 0.9% sodium chloride intravenously during the last 15 min of HD over a period of 6 months. The primary endpoint was the absolute change of the abdominal aortic calcification score. RESULTS: The abdominal aortic calcification score and calcification volume of the abdominal aorta increased similarly in both treatment groups during the trial. As compared with the saline group, patients receiving NaTS exhibited a reduction of their iliac artery calcification score (-137 ± 641 versus 245 ± 755; P = 0.049), reduced pulse wave velocity (9.6 ± 2.7 versus 11.4 ± 3.6; P = 0.000) and a lower carotid intima-media thickness (0.77 ± 0.1 versus 0.83 ± 00.17; P = 0.033) and had better preservation of echocardiographic parameters of left ventricular hypertrophy. No patient of the NaTS group developed new cardiac valve calcifications during the trial as compared with 8 of 29 patients in the saline group. By univariate analysis, NaTS therapy was the only predictor of not developing new valvular calcifications. No adverse events possibly related to NaTS infusion were noted. CONCLUSIONS: While NaTS failed to retard abdominal aortic calcification progress, it positively affected calcification progress in iliac arteries and heart valves as well as several other cardiovascular functional parameters.
Authors: Zheng Qin; Ruoxi Liao; Yuqin Xiong; Luojia Jiang; Jiameng Li; Liya Wang; Mei Han; Si Sun; Jiwen Geng; Qinbo Yang; Zhuyun Zhang; Yupei Li; Heyue Du; Baihai Su Journal: Ann Transl Med Date: 2021-04
Authors: Miles D Witham; Jennifer S Lees; Myra White; Margaret Band; Samira Bell; Donna J Chantler; Ian Ford; Roberta L Fulton; Gwen Kennedy; Roberta C Littleford; Ian V McCrea; Deborah McGlynn; Maurizio Panarelli; Maximilian R Ralston; Elaine Rutherford; Alison Severn; Nicola Thomson; Jamie P Traynor; Allan D Struthers; Kirsty Wetherall; Patrick B Mark Journal: J Am Soc Nephrol Date: 2020-08-13 Impact factor: 10.121
Authors: Francesco Vieceli Dalla Sega; Francesca Fortini; Paolo Severi; Paola Rizzo; Iija Gardi; Paolo Cimaglia; Claudio Rapezzi; Luigi Tavazzi; Roberto Ferrari Journal: Biology (Basel) Date: 2022-03-09