MO740EFFECT OF DIPHOSPHONATES FOR VASCULAR CALCIFICATION IN CHRONIC KIDNEY DISEASE: A META-ANALYSIS

Abstract

Abstract Background and Aims Vascular calcification is an independent predict factor of cardiovascular mortality and all-cause mortality in chronic kidney disease (CKD) patients. Animals experiments and clinical studies showed the inhibition effect of diphosphonates in vascular calcification, but the results of the studies remains controversial. This meta-analysis aims to evaluate the effects of diphosphonates on vascular calcification in patients with CKD. Method Randomized controlled trials (RCT) and non-RCTs of diphosphonates for the treatment of vascular calcification in CKD patients until September 2020 were searched in the database of PubMed, Embase, Cochrane library, CNKI and Wanfang. Literatures were screened according to the inclusion and exclusion criteria and quality was evaluated by two investigators independently. The standard deviation from mean (SMD) and 95% confidence interval (CI) were used to representthe counting data. Data extracted from the literatures were analyzed with Stata software (version 15.0). Results A total of 6 RCTs and 1 non-RCT with 272 patients were included, characteristics of the studies included are shown in Table 1. Meta-analysis indicated that diphosphonates inhibit vascular calcification in CKD [SMD =-0.297, 95% CI = (-0.591, -0.002), P = 0.049] (Figure 1). Etidronate is the most effective one in treating with vascular calcification (P = 0.020) (Figure 2). But there isn’t significant difference in aortic artery calcification and coronary artery calcification compared with the control group (P>0.05). There was no statistically significant difference in the change of blood calcium, blood phosphate, and serum parathyroid hormone between two groups (all P>0.05). Conclusion Diphosphonates can inhibit the progression of vascular calcification in CKD patients, and it hasn’t obvious effect on blood calcium, blood phosphate, and serum parathyroid hormone. Etidronate is the most promising therapeutic agent.