Risk factors associated with valvular calcification in patients with chronic kidney disease. Analysis of NEFRONA study

Introduction: Patients with chronic kidney disease (CKD) are at high risk of cardiovascular morbidity and mortality. Subclinical cardiac structural alterations have prognostic value in these patients. The aim was to analyse the prevalence of valvular calcification, the evolution and the relationship...

Descripción completa

Detalles Bibliográficos
Autores: Martínez Fernández, Lidia, Sánchez Álvarez, Emilio, Morís de la Tassa, César, Bande Fernández, José Joaquín, María de Lamo, Virtudes, Fernández i Giráldez, Elvira, Valdivielso Revilla, José Manuel, Betriu i Bars, M. Àngels
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universitat de Lleida (UdL)
Repositorio:Repositori Obert UdL
OAI Identifier:oai:repositori.udl.cat:10459.1/73324
Acceso en línea:https://doi.org/10.1016/j.nefroe.2021.08.002
http://hdl.handle.net/10459.1/73324
Access Level:acceso abierto
Palabra clave:Valvular calcification
Risk factors
Chronic kidney disease
Nefrona study
Calcificación valvular
Factores de riesgo
Enfermedad renal crónica
Estudio nefrona
Descripción
Sumario:Introduction: Patients with chronic kidney disease (CKD) are at high risk of cardiovascular morbidity and mortality. Subclinical cardiac structural alterations have prognostic value in these patients. The aim was to analyse the prevalence of valvular calcification, the evolution and the relationship with different risk factors. Material and methods: Part of the sample of the NEFRONA study was randomly selected. Aortic and mitral valve calcification were analysed in echocardiograms performed at the baseline visit and at 24 months. Results: We included 397 patients, the estimated basal glomerular filtrate (eGFR) was 33 ml/min with significant decrease to 30.9 ml/min. There was an increase in the area of carotid and femoral plaque, as well as an increase in patients with aortic and mitral calcification at 24 months. A positive association of mitral calcification at 24 months with age, ankle-brachial index (ABI) and calcium-phosphorus product (CaxP) at baseline visit was observed, without association with eGFR. Aortic calcification at 24 months was positively associated with age, phosphorous and total carotid plaque area at baseline, with no relationship to eGFR. Conclusions: A significant prevalence of valvular calcification was observed in patients with CKD without known cardiovascular disease.Two-year progression was observed independently of the eGFR. Patients with higher risk of mitral valve calcification were those with older age, higher ABI and CaxP product. Patients with a higher risk of aortic calcification were those with older age, higher phosphorous levels and larger area of carotid plaque. Identifying these higher risk patients would help to avoid future cardiovascular events intensifying follow-ups.