Key result
After 12.3 months of follow-up, 46% of incident peritoneal dialysis patients developed de novo valve calcification, with intact parathormone identified as an independent risk factor.
Why the study?
What are the risk factors for de novo development of heart valve calcification in incident peritoneal dialysis patients?
Cohort (n=124)
What are the risk factors for de novo development of heart valve calcification in incident peritoneal dialysis patients?
In incident peritoneal dialysis patients, nearly half develop de novo heart valve calcification within one year, with elevated intact parathormone (iPTH) serving as an independent risk factor.
Elevated iPTH signals higher valve calcification risk in new peritoneal dialysis patients; leaves open whether lowering iPTH alters progression.
BACKGROUND AND AIMS: Cardiac valve calcification (VC) is a frequent complication in chronic kidney disease and is considered a risk factor for all-cause and cardiovascular mortality. However, little is known about the pathophysiology mechanisms that originate it and the factors associated with its development. We undertook this study to analyze the frequency and factors related to de novo development of mitral valve calcification (MVC) and aortic valve calcifications (AVC) in incident peritoneal dialysis (PD) patients. METHODS: A prospective cohort of 124 incident PD patients was studied. Demographic and clinical data were recorded and blood assayed at baseline and after 1 year of follow-up for calcium, phosphorus, glucose, urea, creatinine, cholesterol, triglycerides by spectrophotometry assay; high-sensitivity C-reactive protein (CRP) by immunoturbidimetric ultrasensitive assay, intact parathormone (iPTH) and osteocalcin by electrochemiluminescence, fetuin-A and osteoprotegerin by EDI-ELISA. Valve calcification was evaluated by M-mode bidimensional echocardiogram. RESULTS: Sixty eight percent of patients were male, ages 43 ± 13 years; 51% were diabetic with 1.4 ± 1 months on PD. After 12.3 ± 1 months, 57 patients (46%) developed VC: AVC in 33 (57.8%), MVC in 15 (26.3%) and 9 (15.8%) patients in both valves. There was no correlation between AVC and MCV. In univariate logistic regression analysis, age, diabetes and elevated concentrations of OPG, iPTH and CRP were risk factors for development MVC. In multivariate analysis, only iPTH remained an independent risk factor as was also the case in AVC. CONCLUSIONS: Age, diabetes, osteoprotegerin, parathormone and C-reactive protein are risk factors related to de novo development of MVC and iPTH for AVC in incident dialysis patients.
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Ávila–Díaz et al. (2013) conducted a cohort in Incident peritoneal dialysis (n=124). Clinical and biochemical risk factors (including iPTH, age, diabetes, OPG, CRP) vs. Patients without these risk factors was evaluated on De novo development of valve calcification (mitral and aortic). After 12.3 months of follow-up, 46% of incident peritoneal dialysis patients developed de novo valve calcification, with intact parathormone identified as an independent risk factor.
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