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Predictors of mortality in end-stage renal disease patients with mitral annulus calcification

A I Al-Absi1, B M Wall, N Aslam

  • 1Department of Medicine, Divisions of Nephrology and Cardiology, Veterans Affairs Medical Center, Memphis, Tennessee 38104, USA.

The American Journal of the Medical Sciences
|March 16, 2006
PubMed

Insights

Mitral annulus calcification (MAC) did not increase mortality risk in end-stage renal disease (ESRD) patients. However, ESRD itself, along with other cardiovascular conditions, independently predicted mortality in these patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Public Health

Background:

  • Mitral annulus calcification (MAC) is a known predictor of cardiovascular mortality.
  • End-stage renal disease (ESRD) is associated with increased cardiovascular risk.
  • Understanding MAC's impact in ESRD patients is crucial for risk stratification.

Purpose of the Study:

  • To assess risk factors for long-term mortality in ESRD patients with MAC.
  • To compare mortality in ESRD patients with MAC versus those without MAC.
  • To compare ESRD patients with MAC to non-ESRD patients with MAC.

Main Methods:

  • Historical cohort study design.
  • Kaplan-Meier analysis for survival assessment.
  • Cox proportional hazards models for risk factor identification.

Main Results:

  • Median survival was 45 months for ESRD patients with and without MAC, versus 90 months for non-ESRD patients with MAC.
  • In ESRD patients, increased calcium x phosphate product, low serum creatinine, coronary artery disease, and lower extremity amputations predicted mortality.
  • In MAC patients, ESRD presence, atrial fibrillation, diabetes, aortic valve calcification, coronary artery disease, and tricuspid regurgitation predicted mortality.

Conclusions:

  • The mortality rate in ESRD patients is high (approx. 15% annually).
  • MAC did not independently predict mortality in ESRD patients after adjusting for other factors.
  • ESRD itself is a significant predictor of mortality, independent of MAC.
Abstract

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