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. 2022 Dec;44(1):224-232.
doi: 10.1080/0886022X.2022.2032742.

Prognosis and risk factors for cardiac valve calcification in Chinese end-stage kidney disease patients on combination therapy with hemodialysis and hemodiafiltration

Jian-Qiong Xiong  1   2 , Xue-Mei Chen  3 , Chun-Ting Liang  1   4 , Wen Guo  3 , Bai-Li Wu  3 , Xiao-Gang Du  1
Affiliations

Prognosis and risk factors for cardiac valve calcification in Chinese end-stage kidney disease patients on combination therapy with hemodialysis and hemodiafiltration

Jian-Qiong Xiong et al. Ren Fail. 2022 Dec.

Abstract

Background: Cardiac valve calcification (CVC) is an important risk factor for cardiovascular complications. However, limited data are available concerning the prevalence, clinical features and risk factors for CVC in end-stage kidney disease (ESKD) patients. In this study, we aimed to assess these parameters in Chinese ESKD patients receiving combination therapy with hemodialysis and hemodiafiltration.

Methods: We conducted a cross-sectional study on 293 ESKD patients undergoing combination therapy of hemodialysis and hemodiafiltration at the First Affiliated Hospital of Chongqing Medical University from October 2014 to December 2015. CVC was evaluated via echocardiography.

Results: ESKD patients with CVC had a higher prevalence of diabetes mellitus, aortic and/or coronary artery calcification, arrhythmia, heart failure and coronary heart disease; increased systolic, diastolic and pulse pressure; longer duration of hemodialysis and hypertension; reduced hemoglobin, albumin and high-density lipoprotein cholesterol levels; and increased serum calcium and calcium-phosphorus product levels compared with those without CVC. Logistic regression analysis showed that increased dialysis duration (p = 0.006, OR = 2.25), serum calcium levels (p = 0.046, OR = 2.04) and pulse pressure (p < 0.001, OR = 3.22), the presence of diabetes (p = 0.037, OR = 1.81) and decreased serum albumin levels (p = 0.047, OR = 0.54) were risk factors for CVC. The correlation analysis indicated a significantly increased CVCs prevalence with an increase prevalence of heart failure, aortic and coronary artery calcification.

Conclusions: CVC represents a common complication and a danger signal for cardiovascular events in ESKD patients undergoing combination therapy of hemodialysis and hemodiafiltration. The presence of diabetes, increased pulse pressure, long dialysis duration, hypoalbuminemia and high serum calcium levels were independent risk factors for CVC.

Keywords: End-stage kidney disease; cardiac valve calcification; hemodiafiltration; hemodialysis; vascular calcification.

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Figures

Figure 1.
Figure 1.
Flow chart of study design.
Figure 2.
Figure 2.
Etiology of end-stage kidney disease patients.
Figure 3.
Figure 3.
Calcification in the coronary artery and aorta in ESKD patients. Representative calcification in the left anterior descending branch of coronary artery (red arrow) (A), thoracic aorta (red arrow) (B) and abdominal aorta (red arrow) (C).
See this image and copyright information in PMC

References

    1. Kumar S, Bogle R, Banerjee D.. Why do young people with chronic kidney disease die early? World J Nephrol. 2014;3(4):143–155. - PMC - PubMed
    1. Wang AY, Wang M, Woo J, et al. Cardiac valve calcification as an important predictor for all-cause mortality and cardiovascular mortality in long-term peritoneal dialysis patients: a prospective study. JASN. 2003;14(1):159–168. - PubMed
    1. Li M, Ye ZC, Li CM, et al. The influence of cardiac valvular calcification on all-cause and cardiovascular mortality in maintenance hemodialysis patients. Int Urol Nephrol. 2020;52(5):943–951. - PubMed
    1. Braun J, Oldendorf M, Moshage W, et al. Electron beam computed tomography in the evaluation of cardiac calcification in chronic dialysis patients. Am J Kidney Dis. 1996;27(3):394–401. - PubMed
    1. Zapolski T, Wysokiński A, Janicka L, et al. Aortic stiffness and valvular calcifications in patients with end-stage renal disease. Pol Arch Med Wewn. 2008;118(3):111–118. - PubMed