Relationship between serum phosphorus fluctuation and cardiac valve calcification in maintenance hemodialysis patients

Objective To explore the influencing factors of heart valve calcification in maintenance hemodialysis (MHD) patients, and the relationship between the blood phosphorus fluctuations and heart valve calcification. Methods A retrospective analysis was performed on 110 patients with end-stage renal disease who received hemodialysis regularly at the blood purification center of Zhongnan Hospital of Wuhan University from June 2015 to June 2018. Cardiac ultrasound examination was used to detect calcification of patients' heart valves, and the patients were divided into calcification group and non-calcification group. Their blood phosphorus concentrations retested every three months in the patients were collected, and the fluctuation within 1~3 years (4~12 times) was calculated. Multivariate regression analysis was used to explore the relationship between it and calcification. Results Among 110 hemodialysis patients, 51 (46.4%) had calcification of heart valve. Multivariate regression analysis showed that, age (OR=1.100, 95% CI:1.051~1.150, P<0.001), age of dialysis (OR=1.023, 95% CI:1.004~1.042, P=0.019), primary diabetic nephropathy (OR=3.120, 95% CI:1.070~9.101, P=0.037), blood phosphorus (OR=4.923, 95% CI:1.664~14.571, P=0.004) were independent risk factors for calcification of heart valves. The calcification rate in patients with hyperphosphatemia was significantly higher than that in patients with standard blood phosphorus (P=0.042), those patients with high segment parathyroid hormone (intact Parathyroid Hormone, iPTH) had a much higher calcification rate than those with standard iPTH and low iPTH (P=0.015,0.015). Further analysis revealed that 3-year fluctuation of blood phosphorus in MHD patients was an independent risk factor for calcification of heart valves (P=0.006). Conclusions We study the influence factors of MHD patients with heart valve calcification, and the relationship between the blood phosphorus fluctuations and heart valve calcification, Logistic multifacton andlysis showed that age, age of dialysis, the primary disease of diabetic nephropathy, fluctuations in blood phosphorus and phosphorus are independent risk factors for valvular calcification. Therefore, while controlling blood phosphorus, blood phosphorus should be reduced stably so as to avoid too big fluctuation of blood phosphorus.