Abstract: Objective To explore the risk factors for cardiac valve calcification in maintenance hemodialysis (MHD) patients. Method Patients on hemodialysis for at least 3 months in Ruijin Hospital before July 2011, aged over 18 years, and without history of surgery or catheterization for cardiac valve disease were enrolled in this study. Echocardiography was used to detect the calcification. Fibroblast growth factor 23 (FGF23) was measured by ELISA. The risk factors for valve calcification were analyzed by logistic regression method. Results One hundred and ten MHD patients (64 men and 46 women) with the mean dialysis duration of 41.7 months were enrolled in the study. In the 110 patients, cardiac valve calcification was found in 28 patients (25.5%), in which aortic valve calcification was found in 25 patients (22.7%), mitral valve calcification in 10 patents (9.1%), and both aortic and mitral valve calcification in 6 patients (5.5%). Patients with valve calcification had older age, longer dialysis duration, lower albumin level, higher serum phosphate and higher FGF23, as compared with the patients without valve calcification. Multivariate logistic regression showed that age (OR=1.106), dialysis duration (OR=1.031), albumin level (OR=0.852), serum phosphate (OR=7.420) were independently correlated with cardiac valve calcification (backward stepwise, P＜0.001; Nagelkerke R2 0.555). Conclusion Cardiac valve calcification is prevalent in MHD patients, especially aortic valve calcification. Older age, longer dialysis duration, lower albumin and hyperphosphatemia are the independent risk factors for cardiac valve calcification.

Key words: Hemodialysis, Cardiac valve calcification, Fibroblast growth factor 23, KDIGO