Valvular heart disease in end-stage renal failure patients on maintenance hemodialysis.

ABSTRACT

To determine the presence of, and factors associated with, valvular heart disease in end-stage renal failure patients by M-mode, two-dimensional and Doppler echocardiography. Case series of an unselected group of patients on maintenance haemodialysis. Haemodialysis unit and echocardiography laboratory of the King Fahd Central Hospital, Gizan, Saudi Arabia Sixty patients on haemodialysis for at least 6 months. Main outcome measures: Detection of functional and structural valve abnormalities and their relation to putative aetiological factors. The mean age was 34.4 [SD13.0], range 14-66 years; 31 [51.7%] were men and 29 women. The duratior of dialysis was 37 [SD 29] months with a range of 6-106 months. Mitral regurgitation was found in 20 [33.3%], mitral annular calcification in 3 [5.0%], aortic valve calcification in 5 [8.3%] and tricuspid regurgitation in 8 [13.3%] patients At least one of these lesions was present in 22 [36.7%] patients. No patient had mitral or aortic stenosis. There were significant associations found between left ventricular mass and mitral regurgitation; calcium-phosphate product and aortic valvular calcification; and right ventricular enlargement and tricuspid regurgitation. Mitral and tricuspid regurgitation were common in our dialysis patients. The calcium and phosphate product was found to be an important determinant of aortic valvular calcification. Further studies are needed to determine whether early control of calcium and phosphate levels would prevent the development of this complication