Associated factors of cardiac valve calcification and its prognostic effects among patients with chronic kidney disease: a systematic review and meta-analysis

Zhang, Jialing; Pang, Qian; Wang, Shiyuan; Wu, Leiyun; Zhang, Aihua

doi:10.3389/fcvm.2023.1120634

Cited by 3 publications

(2 citation statements)

References 75 publications

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“…A recent meta-analysis evaluated the correlation between CVC and prognosis of patients with CKD. The results showed that both MVC and AVC had predictive value and that MVC had a higher risk, which is also consistent with our findings 41 . Further evaluation is necessary to determine the underlying mechanisms.…”

Section: Discussionsupporting

confidence: 92%

The association of peritoneal dialysis and hemodialysis on mitral and aortic valve calcification associated mortality: a meta-analysis

Chiu,

Chen,

et al. 2024

Sci Rep

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Cardiac valve calcification (CVC), characterized by the accumulation of calcium in the heart valves, is highly prevalent among patients undergoing dialysis. This meta-analysis aimed to provide an updated summary of recent studies on the prognostic value of CVC in patients undergoing dialysis. We conducted a search of PubMed, Embase, and Web of Science to identify observational studies investigating cardiovascular or all-cause mortality associated with CVC in dialysis patients until March 2023. Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were calculated for the meta-analysis, and the strength and significance of the associations between CVC and mortality outcomes in dialysis patients were assessed. From 6218 initially identified studies, we included 10 critical studies with a total of 3376 dialysis patients in a further meta-analysis. Pooled analyses demonstrated a significant association between CVC and an elevated risk of all-cause and cardiovascular mortality in dialysis patients. In our study, we discovered HRs of 1.592 (95% CI 1.410–1.797) for all-cause mortality and 2.444 (95% CI 1.632–3.659) for cardiovascular mortality. Furthermore, subgroup analysis revealed elevated all-cause mortality among patients with mitral valve calcification (HR 1.572; 95% CI 1.200–2.060) compared to those with aortic valve calcification (HR 1.456; 95% CI 1.105–1.917). Similarly, patients undergoing peritoneal dialysis faced a greater risk for all-cause mortality (HR 2.094; 95% CI 1.374–3.191) than those on hemodialysis (HR 1.553; 95% CI 1.369–1.763). This highlights the possibility of CVC being an independent risk factor for dialysis patients, particularly in relation to mitral valve calcification or peritoneal dialysis.

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Section: Discussionsupporting

confidence: 92%

The association of peritoneal dialysis and hemodialysis on mitral and aortic valve calcification associated mortality: a meta-analysis

Chiu,

Chen,

et al. 2024

Sci Rep

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“…Vascular calci cation is a complex process involving many factors. Until now, risk factors for VC, including older age, longer dialysis vintage, diabetes, hypertension, dyslipidemia, and smoking are con rmed both in CKD cohorts and non-CKD cohorts (30,31). Moreover, hyperphosphatemia, elevated calcium-phosphate product, and hyperparathyroidism are well-recognized predictors of VC in dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Correlation between circulating dephosphorylated uncarboxylated matrix Gla protein and vascular calcification in peritoneal dialysis patients

Mao,

Huang,

Zhou

et al. 2024

Preprint

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Objectives Peritoneal dialysis (PD) patients are prone to develop vascular calcification (VC), which increases the all-cause mortality in PD patients. Dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP) is the inactive form of matrix Gla protein (MGP), and MGP is considered as a potent inhibitor of VC. This study is to explore the association between serum dp-ucMGP and abdominal aortic calcification (AAC) in PD patients. Methods A total 128 PD patients and 120 healthy controls were enrolled into the study. Serum dp-ucMGP was measured by enzyme-linked immunosorbent assay. Lateral plain X-ray films of abdomen were used to evaluate the abdominal aortic calcification (AAC) score (AACS). PD patients were divided into two groups according to the presence or absence of AAC. The relationships between dp-ucMGP levels and AACS were assessed by Spearman analysis and the value of dp-ucMGP in predicting AAC was evaluated by receiver operating characteristic (ROC). Results Serum dp-ucMGP in PD patients were significantly higher than controls. And PD patients with AAC had higher serum dp-ucMGP than that of PD patients without AAC. In 128 PD patients, higher dp-ucMGP was associated with greater risk of present AAC (OR = 2.554, 95%CI 1.415–4.609). The area under ROC curve of dp-ucMGP was 0.9227, the corresponding sensitivity was 0.86, and the specificity was 0.92. Conclusion Serum dp-ucMGP levels were positively associated with the AACS in PD patients. Higher serum dp-ucMGP level is independently associated with AAC in PD patients.

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Prevalence, Clinical Aspects, and Risk Factors of Aortic Stenosis Among Haemodialysis Patients Attending Nephrology Centre of Benghazi

Ezwaie,

Alagoury,

Bushiha

et al. 2024

EMJ Cardiol

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Background: Cardiac valve calcifications (CVC) are common among patients on haemodialysis (HD). The valves most commonly involved are mitral and secondarily aortic valves. In Libya, there is a lack of research in this field. This is the author’s motivation to conduct this study, which has a significant impact on the health status of patients on HD. Objective: To identify aortic valve calcifications (AVC), prevalence of aortic stenosis (AS) in patients on HD, and to determine clinical aspects and risk factors that may lead to the development of AS. Patients and Methods: A cross-sectional study was conducted between May–November 2023 of adult patients on chronic HD who had received haemodialysis for more than 1 year. Patients with previous cardiac surgery, a history of endocarditis, or severe anaemia (haemoglobin <7.5 mg/dL) were excluded. A sample of 48 patients were enrolled in the study, with all patients undergoing clinical, biochemical, and a trans-thoracic echocardiographic evaluation. Results: Patients were aged 31–60 years ±13.2 standard deviation. AS had a prevalence of 6.3%, mitral regurgitation had a prevalence of 33.3%, and CVC was detected in 60.4% of patients on chronic HD, with AVC seen in 52.1% and mitral valve calcification seen in 25%. Patients with AVC were more often females (58.6%). Diabetes was seen in 64.6% of cases, and autosomal polycystic kidney disease was seen in 25%. The authors found that dyspnoea was the most common symptom (66.7%), followed by palpitations (35.4%) and asymptomatic patients (27.1%). Clinically detected AS was observed in three individuals (6.3%). Surprisingly, patients did not exhibit significant differences in age, duration of dialysis, or comorbidities. However, hyperphosphatemia was detected in 56.25% of patients, and hyperparathyroidism was recorded in 64.50%. Conclusion: The study has shown that aortic stenosis is the second most common valvular lesion in patients on chronic HD, preceded by mitral valve regurgitation. However, asymptomatic AVC has the highest prevalence among patients on chronic HD. Hyperphosphatemia and hyperparathyroidism are major risk factors that enhance the calcification of cardiac valves. Value of the Research: Though it is a snapshot study, it addresses an important comorbidity in patients on chronic HD. Namely, prevalence of aortic stenosis, CVCs, and associated risk factors, which had been reported in many regional and global nephrology literature, but the national Libyan literature still lacks such chronic HD patients’ data.

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Associated factors of cardiac valve calcification and its prognostic effects among patients with chronic kidney disease: a systematic review and meta-analysis

Cited by 3 publications

References 75 publications

The association of peritoneal dialysis and hemodialysis on mitral and aortic valve calcification associated mortality: a meta-analysis

The association of peritoneal dialysis and hemodialysis on mitral and aortic valve calcification associated mortality: a meta-analysis

Correlation between circulating dephosphorylated uncarboxylated matrix Gla protein and vascular calcification in peritoneal dialysis patients

Prevalence, Clinical Aspects, and Risk Factors of Aortic Stenosis Among Haemodialysis Patients Attending Nephrology Centre of Benghazi

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