Carotid and valvular calcifications in end stage renal disease

ABSTRACT

In dialysis patients, both atherosclerosis and arteriosclerosis are highly prominent. Fetuin A is a glycoprolein produced predominantly by the liver in adults. Fetuin A is known as the most powerful systemic inhibitor of vascular calcification. To study both carotid and valvular calcification in end-stage renal disease [ESRD] and some of biomarkers including fetuin-A, high sensitivity C-reactive protein [hs-CRP], and interleukin 6 [IL-6]. Subjects and Fifty three patients with [ESRD] aged [31.2 +/- 8.1 years]; 32 patients were men and 21 women, on regular haemodialysis [HD]. They were divided into two groups; 27 of them of less than five years duration on hemodialysis; and 26 of more than five years duration. Compared with seventeen; apparently healthy persons. All studied persons were assessed by CBC; lipid profile, serum albumin; calcium; phosphate, calculated calcium phosphate product [ca x p], Fetuin-A, hs-CRP, and IL-6, performed by using ELISA kits. Doppler for carotid arteries, and echocardiography to the heart. There were sixteen [30.2%] patients with calcified valves; and 23 [43.4%] calcified carotid arteries. Fetuin-A was significantly reduced [p= 0.002], and no significant difference was detected in both hs-CRP [p=0.400], and IL-6 [p=0.464] between ESRJJ patients and controls. Patients with ESRD on chronic HD treatment are predisposed to morbidity from cardiovascular disease more than healthy persons. Controlling the process of vascular calcification [VC] can help patients with ESRD in limiting these cardiovascular problems. Low fetuin-A is independent risk factor for VC which acts as inhibitory factor for this process