Abstract: SA-PO895
Mitral Annular Calcification (MAC) in Stage 5 CKD on Dialysis Therapy (CKD-5D)
Session Information
- Dialysis: Cardiovascular, BP, Volume
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Saleem, Sidra, AIMC/JHL, Lahore, Pakistan
- Sarwar, Shahbaz, DHMC, Lahore, Pakistan
- Naveed, Haris, DHMC, Lahore, Pakistan
- Ittifaq, Afshan, DHMC, Lahore, Pakistan
- Mahmood, Asad, DHMC, Lahore, Pakistan
- Mansur, Abeera, DHMC, Lahore, Pakistan
Background
MAC is a degenerative process involving the mitral valve and is a marker of advanced cardiovascular disease. Prevalence in the general population is upto 10% and increases in advanced age, females, systemic hypertension, hypercholesterolemia, diabetes mellitus (DM), atrial fibrillation, chronic kidney disease, end stage renal disease (upto 40%) and mitral valve prolapse. MAC has also been found in Egyptian mummies as a marker of atherosclerosis in the Horus study.The aims of this study were to assess the prevalence of MAC in CKD-5D patients and correlate with patients' characteristics.
Methods
Echocardiograms were obtained in 84 hemodialysis patients. Association of MAC with patient age, DM,Ischemic Heart Disease (IHD), duration of dialysis, smoking, dyslipidemia, serum calcium and phosphorus (PO4), Intact Parathyroid Hormone (iPTH) was studied. The individual highest values of serum PO4 and iPTH in the course of this study were used. Data was analysed using IBM SPSS v. 22.
Results
The mean age of the patients was 63.38 ± 12.3 years and 48(57%) were males. 36(43%) patients were females. 68 patients(81%) had DM and 79(94%) had hypertension. MAC was present in 37 out of 84(44%) patients. 64(72%) were diagnosed with IHD.
The presence of MAC correlated significantly with IHD(Odds Ratio 6.42, p = 0.006).Mean follow up of the patients was 30.30 ±29.22 months and 37(44%) of the patients suffered mortality during this period. Patients who had been on dialysis for longer than 36 months were also found to be at elevated risk of developing MAC (OR=3.32, p=0.019).
Among these findings we also saw that patients with the following risk factors: serum PO4 greater than 5.5 (OR=2.03), DM (OR=1.95), HTN (OR=3.35), Age >60 (OR=1.83), AFIB (OR=1.28); had an observable increase in incidence of MAC with time but they weren’t statistically significant. There was no correlation between MAC and serum Calcium and iPTH.
Conclusion
MAC is common in hemodialysis patients and correlates significantly with IHD. Etiology of MAC in ESRD is multifactorial and needs to be analyzed further. Our findings support the recommendation by Kidney Disease Improving Global Outcomes (KDIGO) 2017 guidelines on Mineral and Bone Disease on the use of echocardiography for the detection of valvular calcification.