Analysis Of Cardiac Valve Calcification And Its Risk Factors In Patients With Chronic Kidney Disease

Objective To investigate the occurrence and risk factors of cardiac valve calcification(CVC)in patients with chronic kidney disease(CKD).Methods Retrospective analysis 523 patients diagnosed with CKD who were hospitalized in Minda Hospital affiliated to Hubei Minzu University from January to May 2019.The general data,laboratory examination results and cardiac ultrasound data were collected.Calcium phosphorus product was calculated.Estimated Glomerular filtration rate was calculated according to the CKD-EPI formula,and according to the staging standard of CKD,the patients were divided into CKD stage 1-5D.At the same time,778 cases of non-CKD patients hospitalized in other departments were taken as the control group,and the occurrence of CVC and general data were collected.Firstly,the occurrence of CVC and general data of CKD patients and non-CKD patients were analyzed and compared.Then,CKD patients were divided into CVC group and non-CVC group according to the occurrence of CVC,and the clinical data of the two groups of patients were analyzed and compared.Statistical software SPSS 22.0 was used for statistical analysis of the above data.Results 1.The incidence of CVC in CKD patients and non-CKD patients was about 20.3%(106/523)and 14.9%(116/778),respectively,and the incidence of CVC in CKD patients was significantly higher than that in non-CKD patients(P<0.05).The age of patients with CKD at the onset of CVC was significantly lower than those without CKD(P<0.001).However,there were no significant differences in calcification site,calcification amount,gender,smoking history and drinking history in CKD patients compared with non-CKD patients(P>0.05).There were 90 cases(84.9%)of aortic valve calcification,35 cases(33.0%)of mitral valve calcification,2 cases(1.9%)of tricuspid valve calcification,and 19 cases(17%)of both aortic valve and mitral valve calcification in CKD patients.There were 105 cases(90.5%)of aortic valve calcification,34 cases(29.3%)of mitral valve calcification,0 cases of tricuspid valve calcification,and 23 cases(19.8%)of both aortic valve and mitral valve calcification in non-CKD patients.2.In CKD patients,the age,the number of patients complicated with hypertension and diabetes,the number of patients receiving maintenance dialysis,the thickness of ventricular septum,the thickness of left ventricular posterior wall and the levels of C-reactive protein,calcium,phosphorus and the product of calcium and phosphorus in the CVC group were significantly higher than those in the non-CVC group(P<0.05).Both hemoglobin and albumin levels in the CVC group were significantly lower than those in the non-CVC group(P<0.05).3.Among the patients with CKD,144 cases(18.8%)of CKD1~3 patients,18 cases(17.0%)of CKD4 patients,32 cases(30.2%)of CKD5 patients,and 36 cases(34.0%)of CKD5 D patients developed CVC.The incidence of CVC increased gradually with the progression of CKD,and increased significantly in the end stage.4.The multi-factor Logistic regression analysis showed that increase of age(OR 1.028,95% CI 1.010~1.047,P<0.05)and hypoalbuminemia(OR 0.942,95%CI 0.902~0.984,P<0.05)are risk factors of CVC in patients with CKD.Conclusion 1.CKD patients are more likely to develop CVC than non-CKD patients,and the onset age of CVC is younger.2.The incidence of CVC in patients with CKD was about20.3%,with main arterial valve calcification,followed by mitral valve calcification,and tricuspid valve calcification was rare.3.The incidence of CVC increased gradually with the progression of CKD,and increased significantly in the end stage.4.Aging and hypoproteinemia are risk factors for CVC in patients with CKD.