Related Experiment Video
Updated: Jul 11, 2025
A Model of Reverse Vascular Remodeling in Pulmonary Hypertension Due to Left Heart Disease by Aortic Debanding in Rats
Published on: March 1, 2022
Progression of valve heart disease in a cohort of patients undergoing renal replacement therapy
Maria Eduarda Cavalcanti Tompson1, José Arthur Viana de Oliveira Pimentel2, Manuella de Amorim Silva2
1Hospital Memorial Jaboatão, Serviço de Terapia Intensiva, Recife, PE, Brazil.
Insights
Chronic kidney disease (CKD) patients on dialysis have high rates of heart valve disease, especially mitral and aortic. Dialysis duration did not correlate with valve disease occurrence or progression in this study.
Area of Science:
- Nephrology
- Cardiology
- Clinical Medicine
Background:
- Cardiovascular disease is a leading cause of mortality in chronic kidney disease (CKD) patients.
- Valve calcification is a significant predictor of cardiovascular mortality and coronary artery disease in CKD.
- Understanding heart valve disease in CKD is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the frequency of heart valve disease in patients with chronic kidney disease (CKD).
- To identify factors associated with heart valve disease in CKD.
- To assess the progression of heart valve disease in relation to dialysis duration.
Main Methods:
- A retrospective study of 291 CKD patients with valve disease was conducted.
- Patients were categorized by dialysis duration: <5 years, 5-10 years, and >10 years.
- Statistical analyses, including regression models, were used to assess associations between valve disease and dialysis duration, with significance set at p < 0.05.
Main Results:
- Mitral valve disease affected 82.5% and aortic valve disease 65.6% of CKD patients.
- 36.4% of patients developed valve disease over time.
- No significant association was found between dialysis duration and the occurrence or progression of aortic, pulmonary, mitral, or tricuspid valve disease. Secondary hyperparathyroidism was linked to mitral valve disease (OR 2.59).
Conclusions:
- CKD patients undergoing renal replacement therapy have a high prevalence of heart valve disease, particularly mitral and aortic.
- Dialysis duration was not found to be associated with the development or progression of valve disease in this cohort.
- Further research may explore other contributing factors to valve disease in CKD patients.
Introduction:
Cardiovascular disease is an important cause of death among patients with chronic kidney disease (CKD). Valve calcification is a predictor of cardiovascular mortality and coronary artery disease.
Objective:
To assess heart valve disease frequency, associated factors, and progression in CKD patients.
Methods:
We conducted a retrospective study on 291 CKD patients at Hospital das Clínicas de Pernambuco. Inclusion criteria were age ≥ 18 with CKD and valve disease, while those on conservative management or with missing data were excluded. Clinical and laboratory variables were compared, and patients were categorized by dialysis duration (<5 years; 5-10 years; >10 years). Statistical tests, including chi-square, Fisher's exact, ANOVA, and Kruskal-Wallis, were employed as needed. Simple and multivariate binary regression models were used to analyze valve disease associations with dialysis duration. Significance was defined as p < 0.05.
Results:
Mitral valve disease was present in 82.5% (240) of patients, followed by aortic valve disease (65.6%; 86). Over time, 106 (36.4%) patients developed valve disease. No significant association was found between aortic, pulmonary, mitral, or tricuspid valve disease and dialysis duration. Secondary hyperparathyroidism was the sole statistically significant factor for mitral valve disease in the regression model (OR 2.59 [95% CI: 1.09-6.18]; p = 0.031).
Conclusion:
CKD patients on renal replacement therapy exhibit a high frequency of valve disease, particularly mitral and aortic valve disease. However, no link was established between dialysis duration and valve disease occurrence or progression.
Related Concept Videos
01:22Heart Failure Drugs: Diuretics
01:29Heart Failure II: Pathophysiology
01:20Mitral Regurgitation I: Introduction
01:17Pathophysiology of Heart Failure
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:25Chronic Kidney Disease I: Introduction