Relation Between Matrix Gla Protein and Cardiac Vavular Calcifications in Haemodialysis Patients

Abstract

Abstract Background Heart valve calcification was first described a century ago. Its pathologic features were first described by Dewitsky in 1910. Valvular heart disease is common in end-stage renal disease patients. The incidence of valvular heart disease is 5 times greater in dialysis patients than in the general population MGP plays a key role in the inhibition of tissue calcification, which was demonstrated in MGP-deficient mice Objective To detect the prevalence of cardiac valvular calcifications among end stage renal disease patients on prevalent haemodialysis and its relation to Matirx Gla protein. Patients and Methods Enrolled patients were recruited from Ain shams hospitals, divided into two groups according to the presence/absence of valvular calcifications on echocardiographic examination as follows: Group A: included patients with valvular calcifications. Group B: included patients without valvular calcifications. Results In current study, 19 (23.8%) patients showed mitral calcification, 30 (37.5%) showed aortic calcification and 44 (55.0%) had calcification in general as 5 patients had both mitral and aortic calcifications. In current study, the patient who had calcification were significantly older, heavier in weight and BMI and were had HD for longer than those who didn’t have calcification. Patient who had calcification had lower levels of both platelets and urea than those who didn’t have calcification. In current study, the mean ucMGP was 549.5 ± 160.1 and the patient who had calcification had higher levels of ucMGP than those who did not have calcification. There was a significant positive correlation between age, weight, BMI, duration of HD and ucMGP. And there was a significant negative correlation between platelet count, serum albumin and ucMGP. Conclusion In current study, MGP was able to significantly differentiate between patients with and without calcification at a cutoff point (>564 pg/mlv) with sensitivity 86.36%, specificity 97.22. Our study confirmed that older age, hypertension, diabetes mellitus low platelet, higher ucMGP and blood urea are the most predictive parameters of valvular calcifications in hemodialysis patients. Other markers were not associated with valvular calcifications. ucMGP serum levels can significantly differentiate between HD cases with valvular calcifications and those not and those who had findings in CXR.