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Progression of cardiac valve calcification and decline of renal function in CKD patients

Luca Di Lullo1, Fulvio Floccari, Alberto Santoboni

  • 1Department of Nephrology and Dialysis, L Parodi Delfino Hospital, Colleferro, Italy.

Journal of Nephrology
|June 29, 2013
PubMed

Insights

Sevelamer, a phosphate binder, significantly reduced cardiac valve calcification and slowed kidney function decline in chronic kidney disease patients. It also lowered FGF-23, CRP, and phosphorus excretion.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Limited data exists on non-calcium-containing phosphate binders' effects on cardiac valve calcification and kidney function in chronic kidney disease (CKD) patients.
  • This study investigated sevelamer's efficacy in patients with stage 3-4 CKD and valve calcification.

Purpose of the Study:

  • To evaluate the impact of sevelamer hydrochloride on cardiac valve calcification progression.
  • To assess the effect of sevelamer on renal function decline in CKD patients.
  • To analyze changes in parathyroid hormone, FGF-23, CRP, and urinary phosphorus excretion.

Main Methods:

  • A prospective observational study involving 170 outpatients with stage 3-4 CKD and mitral or aortic valve calcification.
  • Patients received sevelamer hydrochloride (1,600 mg/day) for one year.
  • Cardiac valve calcification assessed by echocardiography; renal function by estimated glomerular filtration rate (eGFR); serum and urinary markers were assayed.

Main Results:

  • Sevelamer treatment led to a 79.3% decrease in mitral valve calcification and improved aortic valve calcification scores.
  • Significant slowing of renal function decline (p<0.001) was observed.
  • Reduced serum concentrations of FGF-23 and CRP (p<0.0001) and urinary phosphorus excretion (p<0.0001) were noted.

Conclusions:

  • One-year sevelamer treatment may impede cardiac valve calcification progression in CKD patients.
  • Non-calcium-containing phosphate binders like sevelamer can slow renal function decline.
  • Sevelamer effectively reduces FGF-23, CRP, and urinary phosphorus excretion, indicating broader benefits in CKD management.
Abstract

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