The T50 is indicated for CKD patients 5 and 5D. T50 calcification propensity is a major modifiable cardiovascular risk factor!
Proposed algorithm for T50 in hemodialysis care:
The natural distribution of T50 values in hemodialysis population is 47 – 383 minutes.
The T50 is a newly-discovered, independent, major modifiable cardiovascular risk factor (like cholesterol and high blood pressure). A therapeutic improvement of the T50 value in a patient is expected to improve prognosis. The relationship between T50 and outcome is continuous,
and improvement to the T50 are expected to result in approximately proportional gains in prognosis.
T50 can be improved therapeutically, as demonstrated by increased Mg2+
in dialysate shown to increase the T50 by 50-70 minutes. The treating physician can coordinate multiple therapies to maximize the therapeutic increase in T50. For example, as a rule of thumb,
increasing serum Mg2+
by 0.1 mM increases T50 by ~14 min, whereas lowering serum phosphate by 0.1 mM increases T50 by ~10 minutes.
T50 lowering interventions should be avoided.