The Prevalence of Hypertension, Valve Calcification and Left Ventricular Hypertrophy and Geometry in Peritoneal Dialysis Patients

Yılmaz, Mürvet; Ünsal, Abdülkadir; Öztekin, Erkan; Kesmezacar, Ozgu; Harmankaya, Özlem; Eren, Nezaket

doi:10.1159/000336946

Cited by 12 publications

(12 citation statements)

References 77 publications

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“…Vascular calcification may develop in the common population [1], but may be dramatically accelerated in several clinical disorders, particularly chronic kidney disease (CKD) [2,3,4,5,6,7,8,9,10,11,12,13,14]. Recent observations shed new light on the role of mineralocorticoids in triggering of vascular calcification [6].…”

Section: Introductionmentioning

confidence: 99%

Impact of Aldosterone on Osteoinductive Signaling and Vascular Calcification

et al. 2014

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Vascular calcification is frequently found already in early stages of chronic kidney disease (CKD) patients and is associated with high cardiovascular risk. The process of vascular calcification is not considered a passive phenomenon but involves, at least in part, phenotypical transformation of vascular smooth muscle cells (VSMCs). Following exposure to excessive extracellular phosphate concentrations, VSMCs undergo a reprogramming into osteo-/chondroblast-like cells. Such ‘vascular osteoinduction' is characterized by expression of osteogenic transcription factors and triggered by increased phosphate concentrations. A key role in this process is assigned to cellular phosphate transporters, most notably the type III sodium-dependent phosphate transporter Pit1. Pit1 expression is stimulated by mineralocorticoid receptor activation. Therefore, aldosterone participates in the phenotypical transformation of VSMCs. In preclinical models, aldosterone antagonism reduces vascular osteoinduction. Patients with CKD suffer from hyperphosphatemia predisposing to vascular osteogenic transformation, potentially further fostered by concomitant hyperaldosteronism. Clearly, additional research is required to define the role of aldosterone in the regulation of osteogenic signaling and the consecutive vascular calcification in CKD, but more generally also other diseases associated with excessive vascular calcification and even in individuals without overt disease.

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Section: Introductionmentioning

confidence: 99%

Impact of Aldosterone on Osteoinductive Signaling and Vascular Calcification

et al. 2014

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“…The similar or even higher rates of valve calcification have been reported in several studies in prevalent HD and PD patients. 18,19 However, the reduction recorded valvular calcification is only based on regression in mitral valves calcification. The number of patients with aortic calcifications at the end of the study is even slightly higher.…”

Section: Discussionmentioning

confidence: 99%

Valvular calcification and left ventricular modifying in peritoneal dialysis patients

Rebić¹,

Rašić²,

Hamzić-Mehmedbašić³

et al. 2015

Renal Failure

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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.

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“…In addition, Aronow reported that among people aged over 62 years, those with diabetes were more likely to develop cardiac valve calcification [25]. In another study, peritoneal dialysis patients with cardiac valve calcification had higher systolic blood pressure [26]. In this study, nonetheless, we only found that the course of hypertension was longer and hypertension duration-stage product was higher in the AVC-positive group compared to the AVC-negative group, although multivariate regression analysis revealed no significant difference in these two parameters.…”

Section: Discussionmentioning

confidence: 99%

Risk Factor Analysis of Calcification in Aortic and Mitral Valves in Maintenance Peritoneal Dialysis Patients

Wang

Jiang

Feng

et al. 2013

Kidney Blood Press Res

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Background/Aims: This study aimed to investigate potential risk factors for calcification in aortic and mitral valves in maintenance peritoneal dialysis (MPD) patients. Methods: We enrolled MPD patients who had undergone over 18 months of dialysis in our dialysis center, examined their cardiac valve calcification status by echocardiography, and recorded their biochemical data and dialysis-related indicators. These results were compared by logistic regression analyses to identify the risk factors associated with calcification in aortic and mitral valves. Results: Among the 117 enrolled MPD patients, 41 exhibited calcification in aortic or mitral valves, including 38 with aortic valve calcification (AVC) and 17 with mitral valve calcification (MVC); 14 of them had calcification in both aortic and mitral valves. Multivariate logistic regression analysis revealed that age (OR=1.965, p=0.01), diabetes history (OR=4.693, p=0.029), calcium-phosphorus product (OR=2.373, p=0.001) and prealbumin (OR=0.908, p=0.012) were independently related to AVC, whereas age (OR=3.179, p=0.023), calcium-phosphorus product (OR=6.512, p=0.001), prealbumin (OR=0.885, p=0.033), high-density lipoprotein (OR=19.540, p=0.011) and diabetes history (OR=6.948, p=0.038) were independently related to MVC. Conclusions The incidence of cardiac valve calcification in MPD patients is high, and the incidence of AVC is higher than MVC. Age, diabetes history, calcium-phosphorus product and hypo-prealbuminemia are independent risk factors for AVC, whereas age, calcium-phosphorus product and hypo-prealbuminemia are independent risk factors for MVC.

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The Prevalence of Hypertension, Valve Calcification and Left Ventricular Hypertrophy and Geometry in Peritoneal Dialysis Patients

Cited by 12 publications

References 77 publications

Impact of Aldosterone on Osteoinductive Signaling and Vascular Calcification

Impact of Aldosterone on Osteoinductive Signaling and Vascular Calcification

Valvular calcification and left ventricular modifying in peritoneal dialysis patients

Risk Factor Analysis of Calcification in Aortic and Mitral Valves in Maintenance Peritoneal Dialysis Patients

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