Aortic valve calcification is an independent factor of left ventricular hypertrophy in patients on maintenance haemodialysis

Lam

Clinical Journal of the American Society of Nephrology

et al. 2009

Background and objectives: Residual renal function (RRF) predicts survival and shows an important inverse relation with cardiac hypertrophy in peritoneal dialysis (PD) patients. We hypothesized that valvular calcification and the calcification milieu may be part of the process linking loss of RRF and cardiac hypertrophy.Design, setting, participants, & measurements: A cross-sectional study was conducted by performing two-dimensional echocardiography on 230 PD patients to assess valvular calcification and left ventricular (LV) mass and collecting 24-h urine for estimation of RRF.Results: Patients having valvular calcification had lower RRF than those without. Patients with no RRF showed higher calcium-phosphorus product (Ca ؋ P) and C-reactive protein (CRP). Using multiple logistic regression analysis, every 1-ml/min per 1.73 m 2 increase in residual GFR was associated with a 28% reduction in the risk for valvular calcification. The association was lost after additional adjustment for Ca ؋ P and CRP. Using multiple linear regression analysis, loss of RRF showed significant association with increased LV mass index, but this association was lost after additional adjustment for CRP, Ca ؋ P, and valvular calcification. Patients with all three calcification risk factors, namely inflammation, high Ca؋P, and no RRF, showed the highest prevalence of valvular calcification and had the most severe cardiac hypertrophy.Conclusions: The association among loss of RRF, valvular calcification, and cardiac hypertrophy was closely linked to increased inflammation and high Ca ؋ P in PD patients. These data suggest that valvular calcification and the calcification milieu are part of the processes linking loss of RRF and worsening cardiac hypertrophy in PD.

Section: Discussioncontrasting

confidence: 99%

Is Valvular Calcification a Part of the Missing Link between Residual Kidney Function and Cardiac Hypertrophy in Peritoneal Dialysis Patients?

Lam

Clinical Journal of the American Society of Nephrology

et al. 2009

“…12,13 In HD population, some studies showed that BMI was positively correlated with LVH 14 as in general population, whereas other studies gave different results. 15 In our study, the patients with LVH had higher BMI than those without LVH. Multivariate linear regression showed that BMI was positively correlated with LVMI, and such a positive correlation was elucidated by multivariate logistic regression.…”

supporting

confidence: 45%

BMI, spKt/V, and SBP but Not DBP Are Related to LVH in Chinese Maintenance Hemodialysis Patients

et al. 2011

Objective: Left ventricular hypertrophy (LVH) is the strongest predictor of cardiovascular mortality, the leading cause of death in hemodialysis (HD) patients. This study aims to identify the potential risk factors for LVH in HD patients. Methods: Exactly, 164 patients (84 men and 80 women) who had been on HD treatment for at least 6 months were enrolled. Clinical data were collected. Anthropometric measurements, biochemical analyses, and echocardiography were performed. The risk factors were determined by multivariate linear and logistic regression. Results: In all the patients, the prevalence of LVH was 66.5%. The patients with LVH had higher body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure, and lower single-pool kt/V (spKt/V) compared with those without LVH.

“…inflammation and high Ca Â P) may represent part of the process linking loss of renal function and LVH in patients before dialysis therapy and warrant further longer period of observation. In contrast to other studies, 21,22 which showed that increased transaortic flow velocities or pressure gradients promote LVH in HD patients with aortic valvular calcification and stenosis, our data suggest that the relationship between valvular calcification and LVH in PD patients is unlikely to be explained by valvular stenosis, because neither patient had valvular stenosis. As shown in our study, disorders of balance of vasoactive substances, lower RRF, increase calcification markers, dyslipidemia, and anemia all were associated with valvular calcification and were each associated with LVH.…”

Section: Discussioncontrasting

confidence: 99%

Valvular calcification and left ventricular modifying in peritoneal dialysis patients

Rebić¹,

Rašić²,

Hamzić-Mehmedbašić³

et al. 2015

Renal Failure

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 (p50.05). 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.