Department of Blood Purification, General Hospital of Northern Theater Command, 83 Wen Hua Road, Shenyang, 110016, Liaoning, China.
Department of Nephrology, Jin Qiu Hospital of Liaoning Province (Geriatric Hospital of Liaoning Province), Shenyang, China.
BMC Nephrol. 2022 Jan 22;23(1):43. doi: 10.1186/s12882-022-02670-5.
Cardiac valve calcification (CVC) is common in end-stage renal disease (ESRD). We investigated the effect of CVC on all-cause and cardiovascular (CV) mortality in maintenance hemodialysis (MHD) patients.
A retrospective cohort study was conducted on 434 hemodialysis patients who underwent echocardiography for qualitative assessment of valve calcification with complete follow-up data from January 1, 2014, to April 30, 2021. The baseline data between the CVC and non-CVC groups were compared. The Kaplan-Meier method was used to analyse all-cause and cardiovascular mortality. The association of CVC with all-cause and cardiovascular mortality was evaluated using multivariate Cox regression analysis.
Overall, 27.2% of patients had mitral valve calcification (MVC), and 31.8% had aortic valve calcification (AVC) on echocardiography. Patients with CVC showed significantly higher all-cause (log-rank P < 0.001) and cardiovascular (log-rank P < 0.001) mortality rates than patients without CVC. In multivariate regression analyses, MVC (HR: 1.517, P = 0.010) and AVC (HR: 1.433, P = 0.028) were significant factors associated with all-cause mortality. MVC (HR: 2.340, P < 0.001) and AVC (HR: 2.410, P < 0.001) were also significant factors associated with cardiovascular mortality.
MVC and AVC increased the risk of all-cause and cardiovascular mortality in MHD patients. Regular follow-up with echocardiography could be a useful method for risk stratification in MHD patients.
心脏瓣膜钙化（CVC）在终末期肾病（ESRD）中很常见。我们研究了 CVC 对维持性血液透析（MHD）患者全因和心血管（CV）死亡率的影响。
对 434 例接受超声心动图定性评估瓣膜钙化的血液透析患者进行回顾性队列研究，这些患者的完整随访数据来自 2014 年 1 月 1 日至 2021 年 4 月 30 日。比较 CVC 组和非 CVC 组的基线数据。采用 Kaplan-Meier 法分析全因和心血管死亡率。采用多变量 Cox 回归分析 CVC 与全因和心血管死亡率的关系。
总体而言，27.2%的患者在超声心动图上有二尖瓣钙化（MVC），31.8%的患者有主动脉瓣钙化（AVC）。CVC 患者的全因（log-rank P<0.001）和心血管（log-rank P<0.001）死亡率明显高于无 CVC 患者。多变量回归分析显示，MVC（HR：1.517，P=0.010）和 AVC（HR：1.433，P=0.028）是全因死亡的显著相关因素。MVC（HR：2.340，P<0.001）和 AVC（HR：2.410，P<0.001）也是心血管死亡的显著相关因素。
MVC 和 AVC 增加了 MHD 患者全因和心血管死亡的风险。定期进行超声心动图随访可能是 MHD 患者进行风险分层的有用方法。
