Cardiac valve calcification in predialysis chronic kidney disease patients: Prevalence and risk factors

Abstract

Valvular calcification is a common finding in patients with end-stage chronic kidney disease (CKD) and associated with increased all-cause and cardiovascular mortality. The aim of the study was to determine the prevalence and risk factors associated with cardiac valve calcification in patients with stage IV and V CKD, not yet on dialysis. The study enrolled 61 CKD patients (34 M, mean age 62.6±13.6 years) and 22 ageand sex-matched healthy controls. All participants underwent a clinical assessment, laboratory analyses, echocardiography and carotid artery ultrasound. Calcification of the aortic and mitral valve was more frequently in patients with CKD stages IV-V than the healthy controls (47.5% : 9.1%, p=0.001). CKD patients were divided according to the presence of valvular calcification in 2 groups: group A with calcification (n=29) and group B without calcification (n=32). Patients from group A were significantly older (p<0.01), had lower creatinine clearance (p<0.01), and higher levels of P (p <0.05), CaxP product (p<0.05) and PTH (p<0.05) compared to patients from group B. Echocardiography showed a higher prevalence of left ventricular hypertrophy (LVH, p<0.01) in group A compared with group B. In patients of group A, carotid intima-media thickness (IMT) was higher (p<0.001) and calcified plaques were more frequent (p=0.005) than those in group B. Valvular calcification is highly prevalent in the predialysis period of CKD and is associated with disorders of mineral metabolism, left ventricular hypertrophy and vascular calcification.