We examined the influence of cinacalcet on vascular calcification by measuring the coronary artery calcification score (CACS) in hemodialysis patients who received cinacalcet. The cinacalcet treatment group consisted of eight hemodialysis patients with secondary hyperparathyroidism who received cinacalcet for 7-14 months. The mean CACS change in the treatment group was -0.094/year, showing a decreasing tendency, while that in the control group showed an increasing tendency of 0.034/year. The mean CACS change showed a tendency for improvement in the treatment group, but no significant difference from that in the control group was observed as the number of cases was small (P = 0.102). The results of this study suggest that cinacalcet is effective in preventing the progress of extraosseous calcification.
Administration of ticlopidine, a new inhibitor of platelet aggregation, during hemodialysis to two patients with thrombotic occlusion of external A-V shunts markedly suppressed the obstruction of the shunt and improved anemia. Consequently, it was concluded that this drug may be useful for maintaining good blood flow and good patency of shunts in patients undergoing dialysis. In order to determine the dialyzer efficiency during dialysis, the reduction rate of the dialyzer was determined in vitro. The dialyzer reduction rates for urea, creatinine, uric acid, and phosphoric acid were all lowered after dialysis, and the administration of ticlopidine resulted in a suppression of the drop in the reduction rate. Based on the inhibitory effect of ticlopidine on platelet aggregation, it was assumed that a close correlation may exist between adhesion and aggregation of platelets and the drop in the efficiency of the dialyzer during dialysis as well as thrombotic obstruction of shunts.
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