A study on prevalence of cardiac valvular calcification and its correlation with serum phosphate levels in chronic kidney disease

Authors

  • S. Hariprasad Department of General Medicine, ESIC Medical College and PGIMSR, Chennai, Tamil Nadu, India
  • P. Senthilnathan Department of General Medicine, ESIC Medical College and PGIMSR, Chennai, Tamil Nadu, India
  • A. R. Malathy Department of General Medicine, ESIC Medical College and PGIMSR, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20183119

Keywords:

Calcification, Cardiac, Kidney, Serum phosphate, Valvular

Abstract

Background: Higher cardiovascular morbidity found to be more in early stages of chronic kidney disease patients. Present study was done to study the prevalence of cardiac valvular calcification correlated with serum phosphate levels in chronic kidney disease.

Methods: A total of 153 (78 chronic kidney disease patients, 75 controls with age and sex matched) coming to ESIC Hospital, Chennai were utilized to conduct the present study. Patients of stages 3 to 5 with matched controls of age and sex were considered for this study. Cases were classified in to different stages of chronic kidney disease based on estimated Glomerular Filtration Rate which was calculated using Cockcroft-Gault equation using age, body weight, and serum creatinine. The blood samples of patients belonging to both the groups were tested for serum creatinine and serum phosphate. The Echocardiogram was done for the patient with chronic kidney disease to assess cardiac valvular calcification.

Results: 51% of the subjects in the study group were detected as having chronic kidney disease in ultrasonogram. 20% of the patients in the study group were having coronary artery disease compared to 4% in the control group. Mean serum phosphate levels between subjects with Valvular calcification in chronic kidney disease and without calcification was statistically significant among the study group was noted in the present study.

Conclusions: Elevated levels of serum phosphate correlated with cardiac valvular calcification showed significant role in chronic kidney disease.

References

Tonelli M, Wiebe N, Culleton B, House A, Rabbat C, Fok M et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol. 2006;17:2034-47.

Rajapurkar MM, John GT, Kirpalani AL, Abraham G, Agarwal SK, Almeida AF et al. What do we know about chronic kidney disease in India: first report of the Indian CKD registry. BMC Nephrol. 2012;13:10.

Amaresan MS. Cardiovascular disease in chronic kidney disease. Indian J Nephrol. 2005;15:1-7.

Shanahan CM, Crouthamel MH, Kapustin A, Giachelli CM. Arterial calcification in chronic kidney disease: key roles for calcium and phosphate. Circ Res. 2011;109(6):697-711.

Shimada T, Kakitani M, Yamazaki Y, Hasegawa H, Takeuchi Y, Fujita T et al. Targeted ablation of FGF 23 demonstrates an essential physiological role of FGF23 in phosphate and vitamin D metabolism. J Clin Invest. 2004;113(4):561-8.

Hoenderop JG, van Leeuwen JP, van der Eerden BC, Kersten FF, van der Kemp AW, Mérillat AM et al. Renal Ca2+ wasting, hyperabsorption, and reduced bone thickness in mice lacking TRPV5. J Clin Invest. 2003;112(12):1906-14.

Takeda E, Yamamoto H, Nashiki K, Sato T, Arai H, Taketani Y. Inorganic phosphate homeostasis and the role of dietary phosphorus. J Cell Mol Med. 2004;8(2):191-200.

Linefsky JP, O'Brien KD, Katz R, De Boer IH, Barasch E, Jenny NS et al. Association of serum phosphate levels with aortic valve sclerosis and annular calcification - the cardiovascular health study. Am Coll Cardiol J. 2011;58(3):291-297.

Eddington H, Hoefield R, Sinha S, Chrysochou C, Lane B, Foley RN et al. Kalra. Serum phosphate and mortality in patients with chronic kidney disease-case control study. Am Soc Nephrol J. 2010;5:2251-7.

Kestenbaum B, Sampson JN, Rudser KD, Patterson DJ, Seliger SL, Young B et al. Serum phosphate levels and mortality risk among people with CKD – a cohort study. J Am Soc Nephrol.2005;6:520-8.

Adeney KL, Siscovick DS, Ix JH, Seliger SL, Shlipak MG, Jenny NS, Kestenbaum BR. Association of serum phosphate with vascular and valvular calcification in moderate CKD. J Am Soc Nephrol. 2009;20:381-7.

Shaarawy AE, Hosny M, Raafat M, Gendy N. Study of cardiac valvular calcification in ESRD patients on hemodialysis – a single center study. Life Sci J. 2012;9(3):190-216.

Fox E, Harkins D, Taylor H, McMullan M, Han H, Samdarshi T et al. Epidemiology of mitral annular calcification and its predictive value for coronary events in Africans Americans. The Jackson cohort of the atherosclerotic risk in communities study. Am Heart J. 2004;148:979-84.

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Published

2018-07-23

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Original Research Articles