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[Risk factors associated with valvular calcification in patients with chronic kidney disease. Analysis of NEFRONA

Lidia Martínez Fernández1, J Emilio Sánchez-Alvarez2, César Morís de la Tassa1

  • 1Hospital Universitario Central de Asturias, Oviedo, Asturias, España.

Nefrologia
|December 28, 2020
PubMed

Insights

Valvular calcification is common in chronic kidney disease (CKD) patients and progresses over two years. Risk factors for mitral calcification include age, ABI, and CaxP; aortic calcification is linked to age, phosphorus, and carotid plaque.

Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Biology

Background:

  • Patients with chronic kidney disease (CKD) face elevated risks of cardiovascular morbidity and mortality.
  • Subclinical cardiac structural changes, particularly valvular calcification, are significant prognostic indicators in CKD.
  • Understanding the prevalence and progression of valvular calcification is crucial for managing cardiovascular risk in CKD.

Purpose of the Study:

  • To determine the prevalence and 24-month evolution of aortic and mitral valve calcification in CKD patients.
  • To investigate the association between valvular calcification and various cardiovascular risk factors, including estimated glomerular filtration rate (eGFR).
  • To identify patient subgroups at higher risk for developing valvular calcification.

Main Methods:

  • A cohort of 397 CKD patients from the NEFRONA study was analyzed.
  • Echocardiograms were performed at baseline and 24 months to assess aortic and mitral valve calcification.
  • Statistical analyses examined associations between calcification and risk factors like age, eGFR, ankle-brachial index (ABI), calcium-phosphorus product (CaxP), and carotid plaque area.

Main Results:

  • A significant prevalence of valvular calcification was observed in CKD patients without prior cardiovascular disease.
  • Over 24 months, there was a progression in valvular calcification and carotid plaque area, independent of eGFR.
  • Mitral calcification was associated with older age, higher ABI, and CaxP at baseline.
  • Aortic calcification was associated with older age, higher phosphorus levels, and larger carotid plaque area at baseline.

Conclusions:

  • Valvular calcification is prevalent and progressive in CKD patients, even without known cardiovascular disease.
  • Progression of valvular calcification occurs independently of eGFR over a two-year period.
  • Identifying patients with higher risk factors (age, ABI, CaxP, phosphorus, carotid plaque) can guide intensified monitoring to prevent cardiovascular events.
Abstract

Keywords:
Calcificación valvularChronic kidney disease Nefrona studyEnfermedad renal crónicaEstudio nefronaFactores de riesgoRisk factorsValvular calcification

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