Key result
Age >55 years, GFR <53 mL/min/1.73m2, and RRT >20 months, along with chronic inflammation and secondary hyperparathyroidism, are strongly associated with cardiac valve calcification in CKD.
Why the study?
CKD is associated with higher valvular disease prevalence and cardiovascular mortality, but factors influencing cardiac valve calcification in these patients are not well-defined.
What are the clinical and laboratory risk factors for cardiac valve calcification in patients with chronic kidney disease?
Systematic Review (n=13,314)
Yes
What are the clinical and laboratory risk factors for cardiac valve calcification in patients with chronic kidney disease?
In patients with CKD, older age, longer duration of renal replacement therapy, chronic inflammation, and secondary hyperparathyroidism are strongly associated with the development of cardiac valve calcification.
Background: Chronic kidney disease (CKD) is associated with a higher prevalence of valvular diseases and increased mortality from cardiovascular causes. Factors that influence the genesis of cardiac valve calcification (CVC) in these patients are not well-defined. Objective: To determine the risk factors for valvular calcification in patients with CKD. Methods: Systematic review based on PRISMA, which included observational studies evaluating the association of clinical and laboratory data with CVC in patients with CKD, undergoing or not hemodialysis or peritoneal dialysis. Articles were retrieved from databases (MEDLINE; SCIELO; CENTRAL; EMBASE; LILACS/BVS) and selected blindly by two authors; discrepancies were resolved by a third author. Data collection and synthesis were carried out by the main author. The assessment of methodological quality and risk of bias was based on STROBE and Newcastle-Ottawa guidelines. Results: A total of 783 studies were identified, of which 20 were included, encompassing 13,314 patients from 10 countries. The factors most strongly associated with CVC were age >55 years, glomerular filtration rate <53 mL/min/1.73m2, renal replacement therapy (RRT) >20 months, hypoalbuminemia, C-reactive protein (CRP), serum levels of IL-6, TNF-α, parathyroid hormone, hyperphosphatemia, hypercalcemia, Ca × P product, and FGF-23 resulting from secondary hyperparathyroidism. Both mitral and aortic valves were studied, and no differences were observed between hemodialysis and peritoneal dialysis. Conclusion: Age, RRT, chronic inflammation, and secondary hyperparathyroidism promote calcium and phosphate deposition in the valves, making CKD patients more susceptible to CVC) Monitoring these parameters provides opportunities for prevention and treatment.
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Conceição et al. (2025) conducted a systematic review in Chronic kidney disease (n=13,314). Clinical and laboratory risk factors was evaluated on Cardiac valve calcification. Age >55 years, GFR <53 mL/min/1.73m2, and RRT >20 months, along with chronic inflammation and secondary hyperparathyroidism, are strongly associated with cardiac valve calcification in CKD.
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