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352207

The Prevalence of Valvular and Vascular Calcifications in Prevalent Hemodialysis Patients

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Last updated: 24 Dec 2024

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Abstract

Background: Patients with chronic kidney disease (CKD) are likely to get valve calcification 10-20 years earlier than the normal population secondary to uremia. This condition is typically diagnosed through transthoracic echocardiography. Vascular calcification resulted in arterial stiffness and an increase in pulse wave velocity (PWV) in large elastic-type arteries. The intima-media complex acts as a stand-in marker for atherosclerosis and is where lipids are deposited during plaque development. Objective: This study aimed to estimate the prevalence of valvular and vascular calcifications in hemodialysis patients at Ain Shams Specialized Hospital, Cairo, Egypt. Patients and Methods: A cross-sectional pilot study was conducted on 100 prevalent hemodialysis patients who were maintained on thrice-weekly hemodialysis sessions at Ain Shams Specialized Hospital in the period from January to June 2020. Echocardiography was performed to assess the presence of valvular calcification; PWV was measured to evaluate vascular stiffness. Intima-media thickness (IMT) and carotid plaques were detected using an echo-doppler study of the carotid arteries. Results: The study was conducted on 100 patients undergoing hemodialysis treatment for 6 months. Out of these, 55% of patients were males. Among the studied patients, 15% had mitral valve (MV) calcification, 61% had aortic valve (AV) calcification, and 17% had carotid plaques. Patients with calcification of the MV had an aortic PWV mean of 1.587 m/s. 53.33% of these patients had carotid plaques and the IMT mean was 6.567mm higher than the non-MV calcification group. Patients with aortic AV calcifications had a mean IMT of 5.038 mm and a higher percentage (22.95%) of carotid plaques compared to the non-aortic calcification group. Patients with carotid plaques had higher levels of aortic wave pulse velocity (mean 1.54 m/s) and IMT (mean 7.653mm). Also, there was a significant positive correlation between intimal medial thickness and aortic PWV (p-value= 0.003), and a significant negative correlation between IMT and ejection fraction (p-value=0.048*). Conclusions: Valvular calcification is widespread in individuals on hemodialysis, with AV calcification being more common than MV calcification. Hemodialysis patients with valvular calcifications had a higher incidence of carotid intimal thickness. Aortic wave pulse velocity correlated with increasing carotid intimal thickness and predicted arterial atherosclerosis.
 

DOI

10.21608/ejhm.2024.352207

Keywords

IMT, PWV, CKD, Hemodialysis, MV calcification, AV calcification

Volume

95

Article Issue

1

Related Issue

46984

Issue Date

2024-04-01

Receive Date

2024-04-28

Publish Date

2024-04-01

Page Start

1,649

Page End

1,657

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_352207.html

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https://ejhm.journals.ekb.eg/service?article_code=352207

Order

56

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

The Prevalence of Valvular and Vascular Calcifications in Prevalent Hemodialysis Patients

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Type

Article

Created At

24 Dec 2024