Key result
Cardiac valvular calcification in ESRD patients on hemodialysis was significantly associated with older age, longer dialysis duration, and higher calcium-phosphorus product (p=0.0001).
Cross-Sectional (n=85)
No
p-value: p=0.0001
Higher doses of calcium and vitamin D3, along with elevated calcium-phosphorus product, are associated with increased cardiac valvular calcification and dysfunction in ESRD patients on hemodialysis.
Flags high-risk hemodialysis patients for valvular assessment; leaves open whether calcium-phosphorus optimization alters progression.
Cardiac valve calcification are common among patients with chronic kidney disease (CKD). Risk factors include alterations in calcium and phosphorus metabolism, elevated calcium phosphorus product and persistent elevations in plasma parathyroid hormone (PTH). Echocardiography is a simple and inexpensive method for detection of valvular calcifications as suggested by KDIGO guidelines. 60 Patients on regular HD constituted group A (36 males and 24 females) and 25 healthy volunteers constituted group B. Group A was subdivided into: Group I: 21 patients with no valvular calcification, group 2: 26 patients with aortic valve calcification and group 3: 13 patients with aortic and mitral valve calcification. For all, the following was done: clinical examination, serum Ca, serum P, serum albumin, serum creatinine, BUN and PTH level in blood. M-mode echo cardiography was done for all. Age, duration of dialysis and duration of 1ry kidney disease was higher in group 2 and 3 compared to group 1 (p = 0.0001). Calcium was higher in group 2 than group 1 (p = 0.09) and group 3 (p = 0.004) than group I phosphorus was higher in group 2 and 3 than group 1 (P = 0.001). P was higher in group 3 than group 2 (p = 0.0001). Ca x P was higher in group 2 and 3 than group 1 (p = 0.0001), in group 3 than group 2 (p = 0.01) PTH was higher in group 1 than group 2 (p = 0.06). Cardiac dysfunction by echocardiography was least in group 1, increasing in group 2 and being highest in group 3. It was found that calcified valve groups has taken higher doses of Calcium and Vitamin D3 . We have to take care on prescribing Ca and vitamin D3 to ESRD patients on regular HD.
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Shaarawy et al. (2012) conducted a cross-sectional in End-Stage Renal Disease (ESRD) on regular hemodialysis (n=85). Valvular calcification vs. No valvular calcification was evaluated on Calcium-phosphorus (Ca x P) product (p=0.0001). Cardiac valvular calcification in ESRD patients on hemodialysis was significantly associated with older age, longer dialysis duration, and higher calcium-phosphorus product (p=0.0001).
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