DE
DOCTOR INFO
Better diagnostics enable better therapies

Today‘s blood tests provide only fragmented and incomplete information about the calcification system.
Improving CKD patient care today, requires better diagnostics to:
Identify cardiovascular high-risk patients
Coordinate and personalize treatments to reduce Calcification Propensity

The T50 is the only IVD test capable of providing a comprehensive functional assessment of the whole calcification system, and thus a unique insight into the cardiovascular prognosis of a patient. Using the T50 test, therapies can be personalized to reduce Calcification Propensity in cardiovascular high-risk patients.

T50 - THE VALUE WHICH REALLY MATTERS IN CKD!
Because you can only improve what you can measure
Today‘s blood tests only provide
fragmented and incomplete information
about the calcification system.
The T50 provides
a functional assessment
of the whole
calcification system
For a clear view
on what really matters!
CKD care in a nutshell:

• Chronic kidney disease (CKD) affects 9% of the world population.
• Most kidney patients suffer and die from cardiovascular disease.
• Prognosis often as poor as some cancers.


The very high cardiovascular burden is largely caused by impairments of mineral metabolism, commonly referred to as Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD). This disorder is characterized by dysregulation of many key factors, including phosphate, calcium, parathyroid hormone and vitamin D. CKD-MBD results in increased Calcification Propensity, acceleration of vascular calcifications and poor prognosis.

The T50 test measures Calcification Propensity, a major driver of disease progression in CKD patients. The measurement also reflects Phosphate Toxicity, as the calcifications are linked to dysregulation of phosphate in patients.
What does the T50 mean?
The T50 test reports the time necessary for toxic calcified particles (CPP2) to occur in vitro. The T50 result is inversely related to the Calcification Propensity. This means a low T50 result indicates rapid occurrence of CPP2 in vitro, and thus a high Calcification Propensity.

Across studies and across CKD stages, patients with lowest T50 values (highest Calcification Propensity) were associated with worst outcome. Those CKD patients with lowest T50 values are the most vulnerable patients.
How to use the T50?
The T50 is indicated for CKD patients stages 3, 4 and 5. In dialysis patients (stage CKD 5D), the T50 test is recommended to be added to the monthly electrolyte measurements.

Patients with low Calcification Propensity have the best prognosis among CKD patients. Based on the T50 result, no changes to their therapy are necessary.

Patients with high Calcification Propensity have the worst prognosis among CKD patients. The treating physician can consider changes to the therapy to aim at improving the T50 values (and hence prognosis).

Proposed algorithm for T50 in hemodialysis care:
The natural distribution of T50 values in hemodialysis population is 47 – 383 minutes.[2]

The T50 is a newly-discovered, independent cardiovascular risk factor (like cholesterol and high blood pressure) and 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.[4] 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 ~15 min, whereas lowering serum phosphate by 0.1 mM increases T50 by ~10 minutes.

T50 lowering interventions should be avoided.
Material and Shipment
A minimum volume of 0,5 ml of serum (not plasma) is needed. Use gel-containing tubes or separate serum from blood cells before shipment. Shipment at ambient temperature (4-37°C) is possible. Samples should reach the lab within 24 hours after blood drawing.
Where to send
Please contact Calciscon at info@calciscon.com for up-to-date list of accredited medical laboratories offering T50.
Reimbursement
Please contact Calciscon at info@calciscon.com for up-to-date information about reimbursement.
[1]: Smith et al., J Am Soc Nephrol 2014; [2]: Pasch et al., CJASN 2016; [3]: Bundy et al, Am J Kidney Dis 2019 [4]: Bressendorff et al., CJASN 2018
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