Analysis of cardiac valve calcification and dilated left atrium in peritoneal dialysis patients

Abstract

Objectives To evaluate the incidence and associated factors of cardiac valve calcification(CVC) and dilated left atrium in peritoneal dialysis(PD) patients and provide the basis for effective prevention CVC and left atrial enlargement. Methods Eligible patients who were given continuous ambulatory peritoneal dialysis(CAPD) in our hospital were enrolled in present study.Demographic features, blood pressure, laboratory parameters, residual renal function, dialysis adequacy and medication were recorded.Echocardiography was used to assess cardiac valves calcification and left atrial diameter.Risk factors for CVC and left atrial enlargement were analyzed by logistic regression analysis. Results Total of 71 PD patients were enrolled in the study, of which 38 cases were male (53.5%), average age(51.7±15.7)years old, and average age of dialysis (30.04±18.69) months. CVC was presented in 28 patients(39.2%), and dilated left atrium was presented in 31 patients(43.7%). Compared with patients without CVC, patients with CVC were elder(P=0.000), had bigger left atrial diameter(P=0.017). Urea (P=0.028), CTNI(P=0.005) and BNP(P=0.026) were higher, and total lever of KT/V (P=0.007) was lower. Compared with patients without dilated left atrium, patients with dilated left atrium had higher CTNI(P=0.009) and BNP(P=0.005) , and lower ferritin (P=0.002)and total Ccr (P=0.041). Left atrial diameter was positively correlated with age, CTNI, BNP, CVC, and inversely correlated with total serum calcium, ferritin and total Ccr(P<0.05). Age(OR=1.151, 95%CI: 1.072~1.237, P=0.000) and Scr (OR=1.003, 95%CI: 1.000~1.006, P=0.026) were independent correlated with CVC. BUN (OR=1.401, 95%CI: 1.119~1.752, P=0.003), CVC (OR=21.149, 95%CI: 1.737~257.459, P=0.017) were independent correlated with dilated left atrium by logistic regression analysis, while UA(OR=0.982, 95%CI: 0.967~0.997, P=0.017), RBP(OR=0.944, 95%CI: 0.899~0.992, P=0.023), ferritin (OR=0.986, 95%CI: 0.977~0.996, P=0.004) were independent negatively correlated with dilated left atrium. Conclusions CVC and dilated left atrium are prevalent in PD patients.Older age and Scr are independent risk factor for CVC.BUN and CVC are independent risk factor for dilated left atrium, and UA, RBP and ferritin are protective factor for dilated left atrium.Dilated left atrium and CVC are reciprocal causation and closely related each other. Key words: Peritoneal Dialysis; Heart Valve Diseases