Nephrology Dialysis Transplantation, Vol 13, Issue 8 2037-2040, Copyright © 1998 by Oxford University Press
S Ribeiro, A Ramos, A Brandao, J Rebelo, A Guerra, C Resina, A Vila-Lobos, F Carvalho, F Remedio and F Ribeiro
Background. Cardiac valve calcification (VC) has been
detected with increased frequency in haemodialysis (HD) patients, making it
necessary to determine the potential pathogenic factors in uraemic
patients. Methods. A total of 92 chronic HD patients
(39 female, 53 male) and 92 age and gender-matched non-dialysis control
subjects were evaluated by echocardiography and a severity score for VC was
determined. Calcium-phosphate metabolism was evaluated at the beginning of
haemodialysis. Results. We found a greater prevalence
of VC in dialysis patients than in normal patients (mitral annulus 44.5%
vs 10%, P = 0.02; aortic annulus
52% vs 4.3%, P = 0.01). HD
patients with mitral calcification were found to be older than patients
without calcification, were on long-term renal replacement therapy, had
longer duration of predialysis arterial hypertension, had greater values of
the highest value of mean calcium-phosphate product in 6 successive months
(CaxP) and the highest absolute value of calcium-phosphate product
(CaxPmax). We also found a positive correlation between calcification
score, age, and CaxP. No correlation was found between actual VC and
arterial hypertension or parathyroid hormone. Multiple stepwise regression
analysis selected age and CaxP as the most predictive parameters for mitral
calcification (r = 0.47). Mitral calcification was
associated more frequently with rhythm and cardiac conduction defects,
valvular insufficiency and with peripheral vascular calcification. Aortic
calcification was correlated with age (r = 0.42) and
longer duration or pre-dialysis arterial hypertension.
Conclusion. Our study confirmed an increased
prevalence of VC in HD patients and selected age and calcium-phosphate
product as the most predictive parameters. These finding support careful
monitoring of calcium metabolism beginning at the early stages of end-stage
renal failure to reduce the risk of heart disease. Keywords:
calcium; echocardiography; haemodialysis; mitral annulus
calcification; parathyroid hormone; valvular calcification
ORIGINAL ARTICLES
Cardiac valve calcification in haemodialysis patients: role of calcium-phosphate metabolism
Clinica de Doencas Renais, Clinica de Cardiodiagnostico, Lisboa, Portugal; Correspondence to: S Ribeiro, Clinica de Doencas Renais, Av. Forcas Armadas 49, R/C 1600 Lisboa, Portugal
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  F. W. Asselbergs, D. Mozaffarian, R. Katz, B. Kestenbaum, L. F. Fried, J. S. Gottdiener, M. G. Shlipak, and D. S. Siscovick Association of renal function with cardiac calcifications in older adults: the cardiovascular health study Nephrol. Dial. Transplant., March 1, 2009; 24(3): 834 - 840. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Jean, E. Bresson, J.-C. Terrat, T. Vanel, J.-M. Hurot, C. Lorriaux, B. Mayor, and C. Chazot Peripheral vascular calcification in long-haemodialysis patients: associated factors and survival consequences Nephrol. Dial. Transplant., March 1, 2009; 24(3): 948 - 955. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Sullivan, S. S. Sayre, J. B. Leon, R. Machekano, T. E. Love, D. Porter, M. Marbury, and A. R. Sehgal Effect of Food Additives on Hyperphosphatemia Among Patients With End-stage Renal Disease: A Randomized Controlled Trial JAMA, February 11, 2009; 301(6): 629 - 635. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-M. Bugnicourt, J.-M. Chillon, Z. A Massy, S. Canaple, C. Lamy, H. Deramond, and O. Godefroy High Prevalence of Intracranial Artery Calcification in Stroke Patients with CKD: A Retrospective Study Clin. J. Am. Soc. Nephrol., February 1, 2009; 4(2): 284 - 290. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. K. Sampath, P. Simic, S. Moreno, N. Bukanov, N. Draca, V. Kufner, A. Tikvica, A. Blair, D. Semenski, M. Brncic, et al. Sevelamer Restores Bone Volume and Improves Bone Microarchitecture and Strength in Aged Ovariectomized Rats Endocrinology, December 1, 2008; 149(12): 6092 - 6102. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rattazzi, L. Iop, E. Faggin, E. Bertacco, G. Zoppellaro, I. Baesso, M. Puato, G. Torregrossa, G. P. Fadini, C. Agostini, et al. Clones of Interstitial Cells From Bovine Aortic Valve Exhibit Different Calcifying Potential When Exposed to Endotoxin and Phosphate Arterioscler Thromb Vasc Biol, December 1, 2008; 28(12): 2165 - 2172. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Muntner, E. Ferramosca, A. Bellasi, G. A. Block, and P. Raggi Development of a cardiovascular calcification index using simple imaging tools in haemodialysis patients Nephrol. Dial. Transplant., February 1, 2007; 22(2): 508 - 514. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B. Cannata-Andia, M. Rodriguez-Garcia, N. Carrillo-Lopez, M. Naves-Diaz, and B. Diaz-Lopez Vascular Calcifications: Pathogenesis, Management, and Impact on Clinical Outcomes J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S267 - S273. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. M. Chertow, S. Blumenthal, S. Turner, M. Roppolo, L. Stern, E. M. Chi, J. Reed, and on behalf of the CONTROL Investigators Cinacalcet Hydrochloride (Sensipar) in Hemodialysis Patients on Active Vitamin D Derivatives with Controlled PTH and Elevated Calcium x Phosphate Clin. J. Am. Soc. Nephrol., March 1, 2006; 1(2): 305 - 312. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. S. Fox, M. G. Larson, R. S. Vasan, C.-Y. Guo, H. Parise, D. Levy, E. P. Leip, C. J. O'Donnell, R. B. D'Agostino Sr., and E. J. Benjamin Cross-Sectional Association of Kidney Function with Valvular and Annular Calcification: The Framingham Heart Study J. Am. Soc. Nephrol., February 1, 2006; 17(2): 521 - 527. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. R. Nolan Strategies for Improving Long-Term Survival in Patients with ESRD J. Am. Soc. Nephrol., November 1, 2005; 16(11_suppl_2): S120 - S127. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Moe, J. Cunningham, J. Bommer, S. Adler, S. J. Rosansky, P. Urena-Torres, M. B. Albizem, M. D. Guo, V. J. Zani, W. G. Goodman, et al. Long-term treatment of secondary hyperparathyroidism with the calcimimetic cinacalcet HCl Nephrol. Dial. Transplant., October 1, 2005; 20(10): 2186 - 2193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L. Higgins, S. A. Marvel, and J. D. Morrisett Quantification of Calcification in Atherosclerotic Lesions Arterioscler Thromb Vasc Biol, August 1, 2005; 25(8): 1567 - 1576. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. B. Salusky, W. G. Goodman, S. Sahney, B. Gales, A. Perilloux, H.-J. Wang, R. M. Elashoff, and H. Juppner Sevelamer Controls Parathyroid Hormone-Induced Bone Disease as Efficiently as Calcium Carbonate without Increasing Serum Calcium Levels during Therapy with Active Vitamin D Sterols J. Am. Soc. Nephrol., August 1, 2005; 16(8): 2501 - 2508. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Lindberg, B. Culleton, G. Wong, M. F. Borah, R. V. Clark, W. B. Shapiro, S. D. Roger, F. E. Husserl, P. S. Klassen, M. D. Guo, et al. Cinacalcet HCl, an Oral Calcimimetic Agent for the Treatment of Secondary Hyperparathyroidism in Hemodialysis and Peritoneal Dialysis: A Randomized, Double-Blind, Multicenter Study J. Am. Soc. Nephrol., March 1, 2005; 16(3): 800 - 807. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rodriguez, E. Nemeth, and D. Martin The calcium-sensing receptor: a key factor in the pathogenesis of secondary hyperparathyroidism Am J Physiol Renal Physiol, February 1, 2005; 288(2): F253 - F264. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S Joy, A. V Kshirsagar, and N. Franceschini Calcimimetics and the Treatment of Primary and Secondary Hyperparathyroidism Ann. Pharmacother., November 1, 2004; 38(11): 1871 - 1880. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. A. Block, K. J. Martin, A. L.M. de Francisco, S. A. Turner, M. M. Avram, M. G. Suranyi, G. Hercz, J. Cunningham, A. K. Abu-Alfa, P. Messa, et al. Cinacalcet for Secondary Hyperparathyroidism in Patients Receiving Hemodialysis N. Engl. J. Med., April 8, 2004; 350(15): 1516 - 1525. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Shoji, K. Shinohara, E. Kimoto, M. Emoto, H. Tahara, H. Koyama, M. Inaba, S. Fukumoto, E. Ishimura, T. Miki, et al. Lower risk for cardiovascular mortality in oral 1{alpha}-hydroxy vitamin D3 users in a haemodialysis population Nephrol. Dial. Transplant., January 1, 2004; 19(1): 179 - 184. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Bro, J. F. Bentzon, E. Falk, C. B. Andersen, K. Olgaard, and L. B. Nielsen Chronic Renal Failure Accelerates Atherogenesis in Apolipoprotein E-Deficient Mice J. Am. Soc. Nephrol., October 1, 2003; 14(10): 2466 - 2474. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Ventura, N. Tavella, C. Romero, A. Petraglia, A. Baez, and L. Munoz Aortic valve calcification is an independent factor of left ventricular hypertrophy in patients on maintenance haemodialysis Nephrol. Dial. Transplant., October 1, 2002; 17(10): 1795 - 1801. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. H. Malluche and H. Mawad Management of hyperphosphataemia of chronic kidney disease: lessons from the past and future directions Nephrol. Dial. Transplant., July 1, 2002; 17(7): 1170 - 1175. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Minutolo, V. Bellizzi, M. Cioffi, C. Iodice, P. Giannattasio, M. Andreucci, V. Terracciano, B. R. Di Iorio, G. Conte, and L. De Nicola Postdialytic Rebound of Serum Phosphorus: Pathogenetic and Clinical Insights J. Am. Soc. Nephrol., April 1, 2002; 13(4): 1046 - 1054. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. B. Salusky and W. G. Goodman Cardiovascular calcification in end-stage renal disease Nephrol. Dial. Transplant., February 1, 2002; 17(2): 336 - 339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Amin The impact of improved phosphorus control: use of sevelamer hydrochloride in patients with chronic renal failure Nephrol. Dial. Transplant., February 1, 2002; 17(2): 340 - 345. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Y. M. WANG, J. WOO, M. WANG, M. M. M. SEA, R. IP, P. K. T. LI, S. F. LUI, and J. E. SANDERSON Association of Inflammation and Malnutrition with Cardiac Valve Calcification in Continuous Ambulatory Peritoneal Dialysis Patients J. Am. Soc. Nephrol., September 1, 2001; 12(9): 1927 - 1936. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. B. Salusky and W. G. Goodman Managing phosphate retention: is a change necessary? Nephrol. Dial. Transplant., November 1, 2000; 15(11): 1738 - 1742. [Full Text] [PDF]
|
|
|
|
|
|
G. M. LONDON, B. PANNIER, S. J. MARCHAIS, and A. P. GUERIN Calcification of the Aortic Valve in the Dialyzed Patient J. Am. Soc. Nephrol., April 1, 2000; 11(4): 778 - 783. [Full Text] [PDF]
|
|