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De novo development of heart valve calcification in incident peritoneal dialysis patients

Marcela Avila-Díaz1, Carmen Mora-Villalpando, Ma Del Carmen Prado-Uribe

  • 1Medical Research Unit in Nephrology Diseases, CMNS XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico, D.F., Mexico.

Archives of Medical Research
|November 12, 2013
PubMed

Insights

Cardiac valve calcification is common in dialysis patients. Intact parathormone (iPTH) is a key risk factor for developing mitral and aortic valve calcification in peritoneal dialysis patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Cardiac valve calcification (VC) is a common complication in chronic kidney disease (CKD).
  • VC is a significant risk factor for mortality in CKD patients.
  • Pathophysiology and associated factors of VC in CKD remain unclear.

Purpose of the Study:

  • To investigate the frequency of de novo mitral valve calcification (MVC) and aortic valve calcification (AVC).
  • To identify factors associated with the development of MVC and AVC in incident peritoneal dialysis (PD) patients.

Main Methods:

  • Prospective cohort study of 124 incident PD patients.
  • Clinical and demographic data collected; blood assays for calcium, phosphorus, CRP, iPTH, osteocalcin, fetuin-A, osteoprotegerin.
  • Valve calcification assessed via echocardiogram at baseline and after 1 year.

Main Results:

  • 46% of patients developed VC within 12.3 months.
  • AVC occurred in 57.8%, MVC in 26.3%.
  • Multivariate analysis identified intact parathormone (iPTH) as an independent risk factor for both AVC and MVC.

Conclusions:

  • Age, diabetes, osteoprotegerin, parathormone, and C-reactive protein are risk factors for de novo MVC.
  • Intact parathormone (iPTH) is an independent risk factor for de novo AVC in incident PD patients.
Abstract

Keywords:
Cardiovascular diseaseChronic kidney diseaseDiabetesHeart valve calcificationMineral metabolismPeritoneal dialysis

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