Heart valve calcifications in patients with end-stage renal disease: analysis for risk factors.
BACKGROUND
The prevalence of valve calcification (VC) in end-stage renal disease patients is high and information regarding risk factors is scarce. Our aims were to determine the prevalence of VC in our maintenance haemodialysis (HD) population and to examine some possible aetiologic factors for its occurrence.


METHODS
We studied 90 patients (47 women) on maintenance HD for more than 12 months. An M-mode two-dimensional echocardiogram was carried out to evaluate mitral, aortic VC and ventricular geometry. We calculated mean daily calcium intake for the phosphate intestinal chelaing in the previous year to echocardiogram date and also mean values from previous year of Ca, PO4, Ca x PO4, parathyroid hormone, lipide profile, nutritional and inflammatory marquers. Finally consumption of calcium and alfacalcidol was also noted.


RESULTS
Thirty-six patients (40%) presented with VC. Patients with VC were older and showed higher levels of serum calcium (92.00 +/- 7.54 vs 89.27 +/- 6.86 mg/L, P = 0.04), phosphorus (69.70 +/- 18.33 vs 44.90 +/- 12.43 mg/L, P < 0.0001), Ca x P product (6164.97 +/- 1797.64 vs 4024.70 +/- 1066.40 mg(2)/L(2), P < 0.0001) and poor ventricular geometry, as compared with patients without VC. Moreover, they required higher doses of alfacalcidol for treating secondary hyperparathyroidism (0.43 +/- 0.60 vs 0.11 +/- 0.46 microg/day, P < 0.0001).


CONCLUSIONS
Findings of the present study are consistent with a role of altered calcium and phosphate metabolism in the pathogenesis of VC in HD patients.
Tarrass
Faissal
F
Department of Nephrology and Dialysis, Ibn Rochd University Hospital Center, Casablanca, Morocco. faissal76@hotmail.com
Benjelloun
Meryem
M
Zamd
Mohamed
M
Medkouri
Ghislaine
G
Hachim
Khadija
K
Benghanem
Mohamed Gharbi
MG
Ramdani
Benyounes
B
D000328:Adult; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002118:Calcium / Q000097:blood; D004452:Echocardiography; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D015995:Prevalence; D006435:Renal Dialysis; D012307:Risk Factors
D010281:Parathyroid Hormone; D010758:Phosphorus; D002118:Calcium