CitMag Study

Background The risk of cardiovascular disease such as heart attack or stroke and also the risk of death is 10-15-fold higher in dialysis patients compared to kidney-healthy people. Arterial calcification is very common in dialysis patients and is a main contributor to patient disease and risk of death. The tendency of patient blood for calcification can now be measured, and it is known that this measurement of calcification tendency associates with patient survival in dialysis patients. It is a matter of interest, whether this calcification tendency can be improved in patients. Several treatments have been tested so far, and have been found to improve the calcification tendency. Currently it is unclear whether a combination of such treatments leads to further improvements in calcification tendency. Hypothesis We hypothesize that a special composition of the fluid used in dialysis (so-called dialysis bath), namely the combination of citrate with magnesium in the dialysis bath leads to improved calcification tendency of patient blood as compared to the dialysis treatment with a standard dialysis bath. Methods In a prospective, parallel-group, single-center study, we will investigate the effect of a citrate-containing, magnesium-enriched dialysis bath on calcification tendency as compared to dialysis treatment with a standard dialysis bath. Innovation If successful this study could lay the foundation of a new standard of care in dialysis bath prescription. page 1 of 1

A prospective, randomized, open-label study to investigate the influence of the Combination of Citrate and Magnesium in the Dialysis Bath on the Calcification Propensity of Serum in Hemodialysis Patients - The CitMag-Study Background The risk of cardiovascular disease such as heart attack or stroke and also the risk of death is 10-15-fold higher in dialysis patients compared to kidney-healthy people. Arterial calcification is very common in dialysis patients and is a main contributor to patient disease and risk of death. The tendency of patient blood for calcification can now be measured, and it is known that this measurement of calcification tendency associates with patient survival in dialysis patients. It is a matter of interest, whether this calcification tendency can be improved in patients. Several treatments have been tested so far, and have been found to improve the calcification tendency. Currently it is unclear whether a combination of such treatments leads to further improvements in calcification tendency. Hypothesis We hypothesized that a special composition of the fluid used in dialysis (so-called dialysis bath), namely the combination of citrate with magnesium in the dialysis bath leads to improved calcification tendency of patient blood as compared to the dialysis treatment with a standard dialysis bath. Methods In a prospective, parallel-group, single-center study, we investigated the effect of a citrate-containing, magnesium-enriched dialysis bath on calcification tendency as compared to dialysis treatment with a standard dialysis bath. Results There was no significant difference in T50 time between the standard group compared to the citrate-containing, magnesium-enriched dialysis bath group. In longitudinal analyses, serum magnesium concentrations increased with the Mg0.75 dialysate but decreased again with the citrate-containing, magnesium-enriched dialysis bath. Conclusion The combination of citrate-buffer with increased magnesium concentration in dialysate does not improve T50 and may even be antagonistic. Different approaches are needed to improve the calcification tendency of dialysis patients.