Associated factors of cardiac valve calcification and its prognostic effects among patients with chronic kidney disease: a systematic review and meta-analysis

Jialing Zhang; Qi Pang; Shiyuan Wang; Leiyun Wu; Aihua Zhang

doi:10.3389/fcvm.2023.1120634

Associated factors of cardiac valve calcification and its prognostic effects among patients with chronic kidney disease: a systematic review and meta-analysis

Front Cardiovasc Med. 2023 Apr 26:10:1120634. doi: 10.3389/fcvm.2023.1120634. eCollection 2023.

Authors

Jialing Zhang¹, Qi Pang¹, Shiyuan Wang¹, Leiyun Wu¹, Aihua Zhang^{1

2}

Affiliations

¹ Department of Nephrology, Xuanwu Hospital, Capital Medical University, Beijing, China.
² National Clinical Research Center for Geriatric Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China.

Abstract

Background: Cardiac valve calcification (CVC) is highly prevalent and a risk factor for adverse outcomes in patients with chronic kidney disease (CKD). This meta-analysis aimed to investigate the risk factors for CVC and association between CVC and mortality in CKD patients.

Method: Three electronic databases including PubMed, Embase, and Web of Science were searched for relevant studies up to November 2022. Hazard ratios (HR), odds ratios (OR), and 95% confidence intervals (CI) were pooled using random-effect meta-analyses.

Results: 22 studies were included in the meta-analysis. Pooled analyses showed that CKD patients with CVC were relatively older, had a higher body mass index, left atrial dimension, C-reaction protein level, and a declined ejection fraction. Calcium and phosphate metabolism dysfunction, diabetes, coronary heart disease, and duration of dialysis were all predictors for CVC in CKD patients. The presence of CVC (both aortic valve and mitral valve) increased the risk of all-cause and cardiovascular mortality in CKD patients. However, the prognostic value of CVC for mortality was not significant anymore in patients with peritoneal dialysis.

Conclusion: CKD patients with CVC had a greater risk of all-cause and cardiovascular mortality. Multiple associated factors for development of CVC in CKD patients should be taken into consideration by healthcare professionals to improve prognosis.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42022364970].

Keywords: cardiac valve calcification; cardiovascular mortality; chronic kidney disease; mortality; risk factor.

Publication types

Review

Grants and funding

This study was supported by Ministry of Education & National Natural Science Foundation of Beijing (grant no. KZ 202110025038), National Natural Science Foundation of China (grant no. 81873619), the Xuanwu Hospital Huizhi talent leader training program to AZ, and National Natural Science Foundation of China (grant no. 82000710).