Valvular calcification, inflammation, and mortality in dialysis patients

Area of Science:

• Nephrology
• Cardiology
• Biomarkers

Background:

• Valvular calcification (VC) is a common complication in patients with chronic kidney disease.
• Understanding the risk factors for VC in patients initiating dialysis is crucial for risk stratification.
• The association between VC, coronary artery calcification (CAC) progression, and mortality in this population requires further investigation.

Purpose of the Study:

• To identify clinical and physiological correlates of valvular calcification (VC) in incident dialysis patients.
• To investigate the association of VC with coronary artery calcification (CAC) progression.
• To examine the relationship between VC and mortality in individuals new to dialysis.

Main Methods:

• 101 incident dialysis patients underwent electrocardiogram-triggered multislice computed tomography (CT) for calcification assessment.
• Patients were followed for an average of 2.85 years.
• Statistical analyses, including multivariable Poisson regression, were used to determine correlates and associations.

Main Results:

• VC was present in 35.6% of patients, associated with older age, diabetes, cardiovascular disease (CVD), and higher fibrinogen and IL-6 levels.
• Independent correlates of VC included older age, history of CVD, increasing fibrinogen, and presence of CAC.
• Patients with VC showed higher annualized CAC progression and increased mortality rates, particularly with multiple calcified valves.

Conclusions:

• Traditional and novel risk factors are associated with VC in incident dialysis patients.
• VC serves as a significant risk marker for CAC progression.
• VC is associated with increased mortality in patients initiating dialysis, though this association may be confounded by inflammatory markers.