Zhang Jialing, Pang Qi, Wang Shiyuan, Wu Leiyun, Zhang Aihua
Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China.
National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China.
Front Cardiovasc Med. 2023 Apr 26;10:1120634. doi: 10.3389/fcvm.2023.1120634. eCollection 2023.
Cardiac valve calcification (CVC) is highly prevalent and a risk factor for adverse outcomes in patients with chronic kidney disease (CKD). This meta-analysis aimed to investigate the risk factors for CVC and association between CVC and mortality in CKD patients.
Three electronic databases including PubMed, Embase, and Web of Science were searched for relevant studies up to November 2022. Hazard ratios (HR), odds ratios (OR), and 95% confidence intervals (CI) were pooled using random-effect meta-analyses.
22 studies were included in the meta-analysis. Pooled analyses showed that CKD patients with CVC were relatively older, had a higher body mass index, left atrial dimension, C-reaction protein level, and a declined ejection fraction. Calcium and phosphate metabolism dysfunction, diabetes, coronary heart disease, and duration of dialysis were all predictors for CVC in CKD patients. The presence of CVC (both aortic valve and mitral valve) increased the risk of all-cause and cardiovascular mortality in CKD patients. However, the prognostic value of CVC for mortality was not significant anymore in patients with peritoneal dialysis.
CKD patients with CVC had a greater risk of all-cause and cardiovascular mortality. Multiple associated factors for development of CVC in CKD patients should be taken into consideration by healthcare professionals to improve prognosis.
https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42022364970].
心脏瓣膜钙化（CVC）在慢性肾脏病（CKD）患者中非常普遍，是不良预后的危险因素。本荟萃分析旨在探讨CKD患者CVC的危险因素以及CVC与死亡率之间的关联。
检索了包括PubMed、Embase和Web of Science在内的三个电子数据库，以查找截至2022年11月的相关研究。使用随机效应荟萃分析汇总风险比（HR）、比值比（OR）和95%置信区间（CI）。
荟萃分析纳入了22项研究。汇总分析表明，患有CVC的CKD患者年龄相对较大，体重指数、左心房内径、C反应蛋白水平较高，射血分数下降。钙磷代谢功能障碍、糖尿病、冠心病和透析时间都是CKD患者CVC的预测因素。CVC（主动脉瓣和二尖瓣）的存在增加了CKD患者全因死亡和心血管死亡的风险。然而，在腹膜透析患者中，CVC对死亡率的预后价值不再显著。
患有CVC的CKD患者全因死亡和心血管死亡风险更高。医疗保健专业人员应考虑CKD患者发生CVC的多种相关因素，以改善预后。
