Valvular calcification and left ventricular modifying in peritoneal dialysis patients.
BACKGROUND
Cardiac valve calcification (CVC) and left ventricular (LV) alterations are frequent complication in end-stage renal disease (ESRD). We determined the prevalence of CVC and LV hypertrophy (LVH) in ESRD patients before renal replacement therapy and 12 months after peritoneal dialysis (PD).


METHODS
A prospective longitudinal of 50 incident PD patients was studied. Demographic and clinical data were recorded and blood assayed at baseline and after 1-year of follow-up. CVC and LVH were evaluated by M-mode two-dimensional echocardiography.


RESULTS
CVC of the mitral and aortic valves and of both valves were noted in 30, 18 and 10% of patients, respectively. After 12 months of PD regimen, 20% patients had aortic, 24% mitral and 8% had calcification of both valves. After one year of PD, LVH was 62 and 36% in patients with and without CVC, respectively (p < 0.05). Endothelin-1 is an independent predictor of CVC at the baseline, while nitric oxide is inversely an independent predictor at the end of follow-up.


CONCLUSIONS
CVC is associated with LVH in PD patients. These findings identified a potential role for monitored markers to be incorporated into therapeutic strategies aimed at detection and treatment of cardiovascular complications and prevention strategies.
a Clinic for Nephrology and.
Damir
D
Rebić
a Clinic for Nephrology and.
Senija
S
Rašić
a Clinic for Nephrology and.
Aida
A
Hamzić-Mehmedbašić
a Clinic for Nephrology and.
Jasminka
J
Džemidžić
b Clinic for Angiology, University Clinical Center of Sarajevo , Sarajevo , Bosnia and Herzegovina.
Emir
E
Kurtalić
D000328:Adult; D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging; D015415:Biomarkers; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000209:etiology; D004452:Echocardiography; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D011446:Prospective Studies; D055815:Young Adult
D015415:Biomarkers; D019332:Endothelin-1
Biomarkers; cardiac valve calcification; end-stage renal disease; left ventricular alterations; peritoneal dialysis