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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, Spain.

Nefrologia
|September 27, 2022
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:

  • Cardiology
  • Nephrology
  • Vascular Biology

Background:

  • Patients with chronic kidney disease (CKD) face elevated risks of cardiovascular disease (CVD).
  • Subclinical cardiac structural changes, like valvular calcification, are significant prognostic indicators in CKD patients.
  • Understanding valvular calcification prevalence and progression is crucial for CVD risk management 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.
  • To identify patient subgroups at higher risk for valvular calcification progression.

Main Methods:

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

Main Results:

  • A significant prevalence of valvular calcification was found in CKD patients without pre-existing CVD.
  • Valvular calcification showed progression over 24 months, independent of eGFR.
  • Mitral calcification was associated with higher age, ABI, and CaxP at baseline.
  • Aortic calcification was associated with higher age, phosphorus levels, and carotid plaque area at baseline.

Conclusions:

  • Valvular calcification is prevalent and progresses in CKD patients, even without known CVD.
  • Older age, higher ABI, CaxP, phosphorus levels, and carotid plaque area are key risk factors for valvular calcification.
  • Identifying high-risk individuals allows for targeted interventions to prevent cardiovascular events.
Abstract

Keywords:
Calcificación valvularChronic kidney diseaseEnfermedad renal crónicaEstudio nefronaFactores de riesgoNefrona studyRisk factorsValvular calcification

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