Aortic Valve Calcification in Hemodialyzed Patients at the Iraqi Dialysis Center

Abstract

ABSTRACT:BACKGROUND :Aortic valve calcification in End Stage Renal Disease (ESRD) patients occurs ten to twenty years earlier than general population. It is associated with myocardial, coronary arteries and conduction system calcification and it is associated with rapid development of aortic valve stenosis.OBJECTIVE:To study the incidence of aortic valve calcification in hemodialysis patients and to look for risk factors associated with this calcification.PATIENTS AND METHODS:Forty six patients with End Stage Renal Disease (ESRD) on regular haemodialysis in Baghdad Teaching Hospital / Dialysis Unit and forty six patients with no renal disease as control group were studied between February 2005 - January 2006. Duration of dialysis, blood flow rate during dialysis, serum Calcium, serum Phosphorous and their products were included in this study. Echocardiography was done for all patients. RESULT :The incidence of Aortic Valve Calcification (AVC) in ESRD patients on haemodiaysis was 30 % and it was higher than that of general population ( p value 0.0085) . It occurs 10-15 year earlier than in patients with no renal disease. End Stage Renal Disease patients with AVC were older than those with non calcified valves. Only 7.4 % of those ESRD patients with AVC have hemodynamic AV stenosis ( p value 0.5 ). The mean duration of haemodialysis in ESRD patients with AVC was longer than that of ESRD patients without AVC which was statistically significant. Also there was statistically significant association between blood flow rate during haemodialysis and AVC. There was statistically significant association between Calcium phosphate products and AVC in ESRD patients. CONCLUSION:There is ahigher incidence of aortic valve calcification in ESRD patients on haemodialysis . This calcification occurs earlier than that in patients with no renal disease .The duration of haemodialysis is a risk factors for AVC .