Analysis Of The Related Risk Factors For Cardiac Valve Calcification In Patients With Maintenance Hemodialysis

Research background:Hemodialysis is one of the important ways of renal replacement therapy for patients with end stage renal disease.Patients with maintenance hemodialysis will exist a variety of complications,in which cardiovascular complications are the leading causes of death in these patients.Cardiac valve calcification is a risk factor for cardiovascular events in patients with maintenance hemodialysis.Therefore,in order to effectively control the risk factors of cardiac valve calcification,and to improve the quality of life of patients with maintenance hemodialysis and reduce mortality,we initially studied the risk factors of cardiac valve calcification.Research objectives:To explore the incidence and related risk factors of cardiac valve calcification in patients with maintenance hemodialysis.Research methods:Retrospective analysis the data of 172 patients of regular hemodialysis in the first hospital of Jilin University Blood Purification Centre from January 2015 to October 2016.The cardiac valve calcified group and non cardiac valve calcified group were divided,and the ordinary materials such as age,gender,dialysis age were recored.Collect the laboratory index such as blood calcium,blood phosphorus,calcium-phosphorus product,serum parathyroid hormone,triglycerides,high-density lipoprotein cholesterol,low density lipoprotein cholesterol,total cholesterol,hemoglobin,serum albumin,serum prealbumin,alkaline phosphatase,fasting plasma glucose,and heart echocardiography examination results(including cardiac valve calcification and cardiac function index).Access to medical records,and clear the original incidence of patients and whether patients suffer from diabetes,hypertension and myocardial ischemia.Indexes of the patients of two groups were compared.The above statistical methods using SPSS 22 statistical software for analysis.Research results:A total of 172 patients with end stage renal disease were enrolled,including cardiac valve calcified group 79 examples and the non cardiac valve calcifiied group 93 cases,and the incidence of cardiac valve calcification was 45.9%.In cardiac valve calcified group,single mitral valve calcification was 10 cases(12.7%),single aortic valve calcification was 51 cases(64.5%),and mitral valve calcification combined with aortic calcification was 18 cases(22.8%).Mitral valve calcification had a total of 28 cases,in which the mitral annulus calcification was 22 cases(78.6%),and non mitral annulus calcification was 6 cases(21.4%).The clinical data of two groups were compared between cardiac valve calcified group and non cardiac valve calcified group.The age of the cardiac valve calcified group was significantly older than the non cardiac valve calcified group(65.82 + 11.26)vs(47.17 + 13.32)years,(P < 0.01).The dialysis age of the cardiac valve calcified group was longer than the non cardiac valve calcified group(37.35 + 32.99)vs(23.82 + 20.33)months,(P < 0.05).Patients with hypertension and diabetes were more likely to have cardiac valve calcification(P < 0.01),and the hypertension and diabetes duration of the cardiac valve calcified group was longer than the non cardiac valve calcified group(13.32 + 11.10)vs(5.70 + 6.81)years,(P < 0.01);(8.08 + 8.59)vs(2.42 + 5.71)years,(P < 0.01).The results of echocardiography in two groups were compared.The interventricular septum thickness and E/A of the cardiac valve calcified group was greater than that of the non cardiac valve calcified group,and the FS(%)and EF(%)of the cardiac valve calcified group was less than that of the non cardiac valve calcified group.(P < 0.05).Mitral regurgitation of the cardiac valve calcified group happened more than that of the non cardiac valve calcified group(P < 0.05),and aortic regurgitation and myocardial ischemia of the cardiac valve calcified group happened significantly more than that of the non cardiac valve calcified group(P < 0.01).Single factor analysis showed that hemoglobin had an effect on the occurrence of heart valve calcification(P < 0.05).Age,dialysis age,hypertension,diabetes mellitus,blood calcium,blood phosphorus,calcium-phosphorus product,parathyroid hormone,triglycerides,low density lipoprotein cholesterol,total cholesterol,serum albumin,serum prealbumin and fasting blood glucose had an significantly influence on the occurrence of cardiac valve calcification(P < 0.01).Further logistic regression analysis results showed that age,dialysis age,diabetes,blood calcium,calcium-phosphorus product,triglyceride and serum albumin were the influence factors of cardiac valve calcification.Research conclusions:1.Cardiac valve calcification was common in patients with maintenance hemodialysis,mainly including aortic valve calcification and mitral valve calcification,and mitral annulus calcification was common in mitral valve calcification.2.Older age,longer dialysis time,diabetes mellitus,elevated serum calcium,high calcium phosphorus product,high triglyceride and low albumin were independent risk factors for cardiac valve calcification in maintenance hemodialysis patients.3.Cardiac valve calcification in patients with maintenance hemodialysis were prone to cardiovascular complications such as ventricular septal hypertrophy,systolic and diastolic dysfunction,regurgitation of the affected valve and myocardial ischemia.