title: Cardiac valve calcification is a marker of vascular disease in prevalent hemodialysis patients.
abstract: BACKGROUND
  Vascular and valvular calcifications are a common finding in chronic kidney disease (CKD) patients and are associated with increased morbidity and mortality. We investigated the hypothesis that calcification of the cardiac valves is a marker of coronary artery calcification (CAC) and thoracic aorta calcification (AoC) in hemodialysis (CKD-5) patients.
  
  
  METHODS
  This was a cross-sectional study of 145 maintenance CKD stage 5 (CKD-5) patients. All patients underwent electron beam tomography for quantification of CAC and AoC score via the Agatston score. The presence of calcification of the cardiac valves was assessed by standard bi-dimensional echocardiography.
  
  
  RESULTS
  Eighty-four of the study patients (58%) had echocardiographic evidence of valvular calcification. A significant and graded association between valvular calcification and CAC as well as AoC was detected. Patients with 1 or 2 calcified valves had a significantly greater likelihood of having a CAC score >1,000 (odds ratio [OR] = 5.94; 95% confidence interval [95% CI], 1.91-18.44; p=0.002; and OR=3.27; 95%CI, 1.36-7.88; p=0.007, respectively). Similarly, the presence of 1 or 2 calcified valves was associated with an eightfold and threefold increased probability of an AoC score greater than the third quartile, respectively.
  
  
  CONCLUSIONS
  This cross-sectional analysis shows that calcification of the cardiac valves is closely associated with vascular calcification, an established marker of risk in prevalent hemodialysis patients.
authors: Division of Nephrology, Malpighi Hospital, University of Bologna, Bologna, Italy.
authors: Antonio
authors: A
authors: Bellasi
authors: Emiliana
authors: E
authors: Ferramosca
authors: Carlo
authors: C
authors: Ratti
authors: Geoffrey
authors: G
authors: Block
authors: Paolo
authors: P
authors: Raggi
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D002114:Calcinosis; D003430:Cross-Sectional Studies; D005260:Female; D006349:Heart Valve Diseases / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D061205:Vascular Calcification / Q000209:etiology*
chemical_list: D015415:Biomarkers