Prevalence and Risk Factors of Valvular Calcification in Hemodialysis Patients

Abstract

Introduction. Valvular abnormalities frequently occur in patients with chronic kidney failure. This study evaluated the prevalence of heart valve calcification (HVC) in hemodialysis patients and factors associated with it.

Materials and Methods. Medical charts of 129 hemodialysis patients were reviewed retrospectively. Demographic features and laboratory analysis of the patients were systematically recorded. Echocardiographic findings were collected, including ejection fraction, aortic valve calcification (AVC), mitral valve calcification (MVC), left ventricle mass, left ventricle mass index, and pulmonary artery pressure. 

Results. Valvular abnormalities were found in 43 patients (33.3%); 30 patients (23.3%) had MVC, 28 (21.7%) had AVC, and 15 (11.6%) had both MVC and AVC. Patients with HVC were older than other patients (P < .001). On echocardiography, higher left ventricle mass, left ventricle mass index, and pulmonary artery pressure levels were found in patients with HVC. Regarding the lipid profile, serum calcium, serum phosphorus, calcium-phosphorus product, and parathyroid hormone concentrations, there were no significant differences between patients with and without HVC. Ejection fraction levels were significantly lower in patients with HVC (P = .002) and serum albumin level of patients with HVC was significantly diminished.

Conclusions. This study failed to show an association between HVC in hemodialysis patients and calcium-phosphorus product and parathyroid hormone levels; however, age and diabetes mellitus could be regarded as risk factors. In addition, HVC may lead to increased left ventricle mass index and pulmonary artery pressure and decreased ejection fraction, and low albumin levels may be attributable to inflammation.